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An Evaluation to Establish the Acceptable Serum Triglyceride Levels in Neonates Receiving Intravenous Fat Emulsion Infusion in a Multicenter Retrospective Study.
- Source :
-
American journal of perinatology [Am J Perinatol] 2021 Aug; Vol. 38 (S 01), pp. e92-e101. Date of Electronic Publication: 2020 Mar 02. - Publication Year :
- 2021
-
Abstract
- Objective: This study aimed to establish neonatal serum triglyceride (TG) level reference ranges during lipid infusion and correlate peak TG with neonatal outcomes.<br />Study Design: This is a retrospective review of 356 neonates with 696 TG measures obtained in four neonatal intensive care units between 2015 and 2017. TG was evaluated collectively to establish a reference range and a threshold limit. To analyze the effects of a higher TG threshold, neonates were categorized by their peak TG: <180 (TG <superscript><180</superscript> ), 180 to 400 (TG <superscript>180-400</superscript> ), and > 400 mg/dL (TG <superscript>>400</superscript> ). Univariable and multivariable regression models were constructed to compare peak TG to patient characteristic and clinical outcomes.<br />Results: The frequency of TG > 400 mg/dL was 5% and found only in neonates weighing < 1.5 kg. Neonates in the TG <superscript>180-400</superscript> ( n = 91) group were significantly lower in birth weight and gestational age, had lower 5-minute APGAR scores, and had increased ventilatory requirement when compared with neonates in the TG <superscript><180</superscript> ( n = 240) group (all p < 0.001). The TG <superscript>180-400</superscript> group had increased risk of severe intraventricular hemorrhage ( p = 0.02) and bronchopulmonary dysplasia ( p = 0.03). Elevated TG was associated with mortality (odds ratio [OR]: 14.4, p < 0.001) in univariable analysis, but the relationship weakened (OR: 4.4, p = 0.05) after adjusting for comorbidities in multivariable logistic regression.<br />Conclusion: It is unclear if the adverse outcomes seen in neonates with higher peak TG were due to elevated TG alone, or whether illness severity predicted the increased TG. More prospective studies are needed to further delineate the relationships.<br />Competing Interests: None declared.<br /> (Thieme. All rights reserved.)
- Subjects :
- Birth Weight
Bronchopulmonary Dysplasia blood
Bronchopulmonary Dysplasia etiology
Cerebral Intraventricular Hemorrhage blood
Cerebral Intraventricular Hemorrhage etiology
Female
Gestational Age
Humans
Hypertriglyceridemia complications
Infant, Small for Gestational Age
Intensive Care Units, Neonatal
Logistic Models
Male
Odds Ratio
Reference Values
Retrospective Studies
Risk Factors
Triglycerides adverse effects
Fat Emulsions, Intravenous administration & dosage
Fat Emulsions, Intravenous adverse effects
Hypertriglyceridemia mortality
Infant, Newborn blood
Parenteral Nutrition
Triglycerides blood
Subjects
Details
- Language :
- English
- ISSN :
- 1098-8785
- Volume :
- 38
- Issue :
- S 01
- Database :
- MEDLINE
- Journal :
- American journal of perinatology
- Publication Type :
- Academic Journal
- Accession number :
- 32120418
- Full Text :
- https://doi.org/10.1055/s-0040-1705174