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Clinical pharmacy
CP-085 Comparison of bilirubin levels with two intravenous lipid emulsions in premature infants requiring parenteral nutrition
  1. R López-Sepúlveda1,
  2. CM Valencia Soto2,
  3. J Pérez-Morales2,
  4. P Vallecillo-Capilla2
  1. 1Hospital Universitario Virgen de Las Nieves, Pharmacy, Granada, Spain
  2. 2Hospital Universitario Virgen de Las Nieves, Farmacia, Granada, Spain

Abstract

Background Soybean lipid emulsions in parenteral nutrition (PN) are associated with liver disease. This has led to the development of alternative intravenous lipid emulsions (ILEs).

Purpose To compare the effects of two new ILEs: Lipoplus (soybean with fish oil) and Clinoleic (soybean with olive oil).

Material and methods Retrospective observational study using pharmacotherapeutic records of premature infants who started PN between December 2012 and May 2014 in a tertiary care hospital. We included infants requiring ≥5 days of PN with a gestational age <34 weeks and birth weight between 0.5 and 2 kg. Clinical information included gender, gestational age and body weight. Laboratory data recorded included total (TB), conjugated (CB) and unconjugated bilirubin (UB) (mg/dL). Either Lipoplus or Clinoleic was used as the clinician requested. Comparisons were done using t-tests.

Results 24 children were included (16 male and 8 female); 17 (70.8%) treated with Lipoplus and 7 (29.2%) with Clinoleic. Mean gestational age was 29 weeks for both treatments. Average weight at the beginning of PN was 1.23 kg for Lipoplus and 1.32 kg for Clinoleic.

No differences were detected in bilirubin levels between groups at baseline (Lipoplus: CB: 0.9; UB: 8.7; TB: 8.7. vs. Clinoleic: CB: 0.3; UB: 7.8; TB: 9.0; p = n.s.) or at completion of treatment (Lipoplus: CB: 0.7; UB: 9.8; TB: 8.7 vs. Clinoleic: CB: 0.5; UB: 9.2; TB: 9.4; p = n.s.). No decrease in TB, CB or UB vs. baseline was observed for either treatment.

Conclusion We found no significant difference in benefit or less persistent hyperbilirubinaemia between infants treated with Lipoplus or Clinoleic. Treatment with soybean emulsion vs. new ILEs has resulted in a significant decrease in total/conjugated bilirubin vs. baseline.1 However previous studies also showed no significant differences in total/conjugated bilirubin levels between the new ILE treatments.2

References and/or Acknowledgements

  1. M. Rayyan, et al. 2012

  2. J. Pichler, et al. 2014

References and/or AcknowledgementsNo conflict of interest.

http://dx.doi.org/10.1136/ejhpharm-2015-000639.81

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