The 2018 European Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations propose intravenous (IV) lipid titration in cases of hypertriglyceridemia (HiTG) during parenteral nutrition (PN), however, the implications in tiny preterm children remain poorly unclear. Researchers investigated macronutrient and energy intakes, growth, prematurity-related illnesses, and neurodevelopment in tiny preterm babies on PN who developed HiTG (cases) or did not develop HiTG (controls) (controls, CNTR). They evaluated data from preterm children with a birth weight (BW) <1250 g who were hospitalized to our neonatal critical care unit and received routine PN from 2004 to 2016. HiTG newborns had at least 1 triglyceride (TG) measurement >250 mg/dL within the first 10 days of life. For BW and gestational age, patients with and without HiTG were matched.
A total of 658 newborns were examined, with 196 (30%) having HiTG. A total of 136 HiTG patients were matched with 136 CNTR patients. IV lipid, non-protein energy, and total energy intakes were considerably lower in HiTG newborns during the first 10 days of life, but not IV amino acids and carbs. In disorders related to preterm, they observed no differences between groups. Anthropometry at 36 weeks (W), 2-year (Y) corrected age (CA), and neurodevelopment at 2Y CA did not vary.
At 2Y CA, HiTG babies’ growth, illnesses linked with preterm, and neurodevelopment were comparable to CNTR. This happened despite a statistically substantial, albeit minor, reduction in IV lipid and non-protein energy intakes as a result of stringent TG monitoring and IV lipid titration at TG levels more than 250 mg/dL.
Reference:journals.lww.com/jpgn/Fulltext/2019/11000/Hypertriglyceridemia_and_Intravenous_Lipid.21.aspx
