Effects of Parenteral Nutrition With Different Lipid Emulsions in Preterm Infants
Effects of Parenteral Nutrition With Different Lipid Emulsions in Preterm Infants
Previous studies have suggested that olive oil-based emulsion is safe and well tolerated in
 preterm infants, a showed efficacy and a good clinical and biological safety profile. The
 objective of this study was to assess the effects of a new olive-oil based lipid emulsion
 compared with the traditional lipid emulsions.
For a number of years, lipid emulsions have been used in the nutritional support of surgical
 and critically ill patients, with the aim of supplying substrates to meet energy demands and
 providing building blocks for wound healing and tissue repair. Two types of lipid emulsions
 are currently used for adult as well as pediatric patients: one lipid emulsions prepared from
 soybean oil that are composed of long-chain triacylglycerols (LCTs), 62% of which are
 polyunsaturated fatty acids (PUFAs), and the other lipid emulsions composed of 50%
 medium-chain triacylglycerols (MCTs) and 50% LCT soybean oil. A new lipid emulsion prepared
 from a mixture of soybean oil and olive oil contains only LCTs and has a lower proportion
 (20%) of PUFAs and 60% monounsaturated fatty acids (MUFAs). There are so many investigations
 with olive oil-based emulsion including in-vitro studies, animal studies, and infusion
 studies in healthy subjects and in various patient groups. In-vitro and animal studies
 demonstrate that the impairment of immune function, especially of T cell responses, that
 occurs with soybean oil-based emulsions is avoided with ClinOleic. Studies in infants and
 adults have consistently shown that olive oil-based emulsion increases the oleic acid content
 of blood lipids and that it avoids the depletion of long chain n-6 PUFA derivatives of
 linoleic acid that is seen with soybean oil-based emulsion. The less unsaturated nature of
 olive oil-based emulsion compared will possibly decrease oxidative stress. Further studies
 are required to test their beneficial effect from olive oil consumption in preterm infants.

 The investigators designed a double-blind, randomized clinical trial to performed the effect
 of lipometabolism, oxidative stress and clinical outcomes of olive oil , MCY/LCT and LCT
 lipid emulsions.
Inclusion Criteria:

 -  Infants of both genders

 -  Hospitalized

 -  The parent of the infant agreed to participate by signing an informed consent form

 -  Infants admitted hospital within 72 hours after birth(gestational age<37 weeks)

 -  Birth weight <= 2000g

 -  No PN support contraindications

 -  Parenteral nutrition for 14 days or more

 -  The parent of the infant is to sign an informed consent form prior to enrollment

 Exclusion Criteria:

 -  Receiving PN before screening

 -  EN caloric>10%

 -  Obstruction jaundice

 -  Suspected or identified biliary tract atresia

 -  Neonatal hepatitis

 -  Infants with liver markers >2 times normal levels

 -  Infants with renal markers >2 times normal levels

 -  Congenital metabolic situations

 -  Identified as having major chromosomal disease

 -  CMV, virus hepatitis and syphilis infection

 -  Congenital or acquired immune deficiency