Comparison of Intravenous Vs Enteral Administration of Fat Emulsion (Intralipid) in Very Low Birth Weight Infantst

Abstract

The aim of this study was to compare venous and oral administration of fat emulsion in very low birth weight infants and examines their effect on the weight gain of very low birth weight infants and their early complications. Material&Method: This pilot study wase performed by randomized clinical trial on 81 premature infants birth weight 750 to 1500 g in the three groups of oral fat emulsion (27 people), intravenous fat emulsion (27 people) and control (27 people) they was admitted to Al-Zahra Hospital in Tabriz from April 1, 2015 to the end of December 2016. In the first and second groups, they received Total Parenteral Nutrition including amino acids, glucose, electrolytes, phosphorus, and trace elements. In the first group, intravenous administration of fat emulsion (20% Smoff) started from the third day of birth at 1 g / kg and gradually increased to 3 g / kg. In the second group, oral administration of fat emulsion was started from the third to the fifth day of birth at a rate of 1 g / kg and gradually increased to 3 g / kg. In the third group (control), all components of complete venous nutrition were given except fat emulsion. All 3 groups received the same breast milk protocol. In terms of weight gain, patients experienced early complications including mortality, necrotizing enterocolitis, premature retinopathy requiring treatment, sepsis, chronic lung disease, and tolerance to nutrition until discharge from the hospital.Collect the required information with a ouestionnaireand; Results were performed with SPSS22 software and Croscal Wallis, Mann Whitney, Kai Do Square, ANOVA analysis of variance. P v less than 0.05 was considered significant. Result: In the control group, the average birth weight was 1140.38±189.37 grams, in the oral administration group it was1104.63±180.96, and in the intravenous administration group it was1097.78±182.97. However, the differences were not significant according to the ANOVA analysis test (P-value = 0.668) .The three groups did not differ in terms of demographic characteristics (gestational age, birth weight, head circumflex of birth, height of time of birth, gender, method of delivery). The average gestational age of infants in the 3 groups was about 28 weeks. Babies in all three groups lost weight by day seven. Weight loss in infants who used intravenous fat emulsion was significantly lower than in the other two groups. Most infants in the group oral emulsions and intravenous emulsions received to birth weight at 14 days of age (55.84% in the oral administration group and 81.44% in the intravenous group), but neonates in the control group did not reach this weight (Pv =. 044). Nutrition intolerance were reduced faster in the oral administration group (from 5 days of age) and fat tolerance was better. No cholestasis was seen in any group. Patients in 3 groups were not significantly different in terms of mortality and necrotizing enterocolitis, premature retinopathy requiring treatment, sepsis, and chronic lung disease.