Long-term Exposure of Children to a Mixed Lipid Emulsion is Less Hepatotoxic Than Soybean-Based Lipid Emulsion.

Lipid emulsions have been associated with liver injury. Newer mixed emulsions (ML), such as SMOFlipid(R) (Fresenius Kabi, Germany), are thought to be more hepatoprotective than soybean-based emulsions (SL), such as Intralipid(R) (Baxter, U.S.A.). Pediatric studies comparing long-term use between the two are limited. This study compares the severity of hepatic injury between a prospective cohort of hospitalized children on ML (n = 20) and a historical age- and diagnosis-matched cohort of hospitalized children on SL (n = 20). Median exposure to ML and SL were 10 vs. 6 weeks (p = 0.030), respectively, at similar median lipid doses (2.2 g/kg/d vs. 2.1 g/kg/d). Using a generalized estimating equations approach, conjugated bilirubin trajectory was found to be lower in patients on ML compared to SL (p =4 weeks) to ML is associated with decreased liver injury compared to SL in hospitalized children. (C) 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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