The incidence of PNAC is between 25% and 60% among children who receive long-term PN as reported. However, long-term PN can lead to serious complications, such as metabolic disorder, catheter-related bloodstream infection, systemic inflammatory response syndrome, late-onset sepsis (LOS), gastrointestinal mucosal atrophy, and flora imbalance, also includes parenteral nutrition-associated cholestasis (PNAC). ILE ensures proper weight gain in premature infants, provides essential fatty acids and energy, promotes the development of brain nerves and retina, reduces the related complications of premature infants, and improves the success rate of rescue. Intravenous lipid emulsions (ILE) are considered a standard and essential component of PN. Early active PN is known to improve the survival rate and prognosis of VPI or VLBWI. Very preterm infants (VPI) with gestational age (GA) < 32 weeks or very low birth weight infants (VLBWI) with birth weight (BW) < 1500 g in the neonatal intensive care unit (NICU) are completely or partially dependent on parenteral nutrition (PN) in the early postnatal period to meet the nutrient and energy requirements of growth due to the presence of an immature digestive system. SMOF has better lipid tolerance, reduces the incidence of PNAC and MBDP, and exerts more benefits in preterm infants with gestational age < 28 weeks. The application of mixed oil emulsion in VPI or VLBWI can reduce the risk of plasma TB > 5 mg/dL, DB ≥ 2 mg/dL, ALP > 900 IU/L, and TG > 3.4 mmol/L during hospitalization.
In addition, no significant differences were recorded in the incidence of patent ductus arteriosus, feeding intolerance, necrotizing enterocolitis (Bell’s stage ≥ 2), late-onset sepsis, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity and extrauterine growth retardation between the two groups ( P > 0.05).
Multivariate logistic regression analysis revealed that the incidence of PNAC (a RR: 0.38, 95% confidence interval : 0.20–0.70, P = 0.002) and MBDP (a RR: 0.12, 95% CI: 0.19–0.81, P = 0.029) in the SMOF group were lower than that in the MCT/LCT group. Compared with the MCT/LCT group, the incidence of neonates with a peak value of total bilirubin (TB) > 5 mg/dL (84/231 ), a peak value of direct bilirubin (DB) ≥ 2 mg/dL (26/231 ), a peak value of alkaline phosphatase (ALP) > 900 IU/L (17/231 ), and a peak value of triglycerides (TG) > 3.4 mmol/L (13/231 ]) were lower in the SMOF group ( P 28 weeks group ( P = 0.177 and 0.991, respectively). This study compared the clinical effects of two different lipid emulsions in premature infants with gestational age 0.05).
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