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- Title
Parenteral fish oil lipid emulsion use in adults: a case series and review from an intestinal failure referral center.
- Authors
Hakimian, David; Wall, Elizabeth; Herlitz, Jean; Lozano, Edward Scott; McDonald, Edwin; Semrad, Carol; Micic, Dejan
- Abstract
Background: Intestinal failure-associated liver disease (IFALD) is a complication of long-term PN use, attributed to the use of ω-6 injectable lipid emulsions (ILE). Fish oil (FO) ILE have been successful in reversing liver injury in neonates. Evidence for pure FO ILE use in adult patients is limited. Methods: Case series of the use of FO lipid emulsions in adults with IFALD from the University of Chicago PN registry. Analysis of medical charts and PN formulations was performed. Results: Three cases of IFALD treated with FO ILE were identified. The first case was a 30-year-old man with short bowel syndrome (SBS), hyperbilirubinemia, and biopsy-proven IFALD. Following a change from a soy lipid emulsion to FO lipid emulsion, his liver tests rapidly improved and remained stable over 202 weeks of use. The second case was a 76-year-old woman with intestinal failure (IF) due to a frozen bowel. A change from a soy ILE to a composite lipid and later to a pure FO ILE did not result in improvement in her liver tests. The third case was a 28-year-old man with SBS and biopsy-proven IFALD. Change to a composite ILE and subsequently FO lipid emulsion resulted in a gradual improvement in liver tests. No clinical essential fatty acid (EFA) deficiencies were identified during treatment. Conclusion: FO ILE may be effective in the treatment of adult patients with cholestatic IFALD. Use is safe with no EFA deficiencies detected in up to 4 years of use.
- Subjects
UNITED States; SOYFOOD therapy; BIOPSY; PARENTERAL feeding; HYPERBILIRUBINEMIA; PATIENT safety; INTESTINAL diseases; FISH oils; LIVER diseases; INTRAVENOUS fat emulsions; SHORT bowel syndrome; CASE studies; MEDICAL referrals; CHOLESTASIS; ADULTS
- Publication
European Journal of Clinical Nutrition, 2024, Vol 78, Issue 9, p796
- ISSN
0954-3007
- Publication type
Article
- DOI
10.1038/s41430-024-01462-4