A Randomized Trial of Micropreemies Receiving Higher Amounts of Intravenous Fat Emulsion During the First Week of Life

Abstract

Objective. The goal of this study was to determine if micropreemies could tolerate higher infusion rates of intravenous fat emulsions (IVFEs) during the first week of life by maintaining their serum triglyceride levels at <200 mg/dL. Methods. This was a randomized controlled trial of 19 infants who were classified as appropriate for gestational age and had birth weights between 500 and 750 g. The primary clinical outcome was serum triglyceride levels; secondary outcomes also were monitored. Results. A total of 19 micropreemies completed the study (experimental group: n = 10; control group: n = 9). Of the infants in the experimental group, 100% had developed hypertriglyceridemia (>201 g/dL) during the first week of life compared with only 44.4% of the infants in the control group. The experimental group experienced a lower weight loss of 8.6% ± 3.10% as compared with 16.22% ± 8.04% in the control group during the first week of life. Initially, the experimental group was given significantly higher infusion rates of IVFEs, but at the end of the week, the control group was receiving significantly higher infusion rates of IVFEs. Calorie intake was significantly better initially for the experimental group, but because of the incidences of hypertriglyceridemia and a reduction of IVFEs, the control group had significantly better calorie intake at the end of the study period. Conclusions. Micropreemies do not tolerate initial higher infusion rates of IVFEs during the first week of life because of their potential risk for developing hypertriglyceridemia.