Fish oil-based lipid emulsion in the treatment of parenteral nutrition-associated cholestasis

Simonetta Costa, Rossella Iannotta, Luca Maggio, Giovanni Barone, Francesca Serrao, Giovanni Vento

Research output: Contribution to journalArticlepeer-review


Background: Parenteral nutrition-associated cholestasis (PNAC) is a serious complication in preterm infants receiving prolonged parenteral nutrition. Soybean lipid emulsion (SLE) seems to have a role in its pathogenesis, whereas fish oil-based emulsion (FOLE) seems to be able to reverse cholestasis. This study aimed to evaluate the effectiveness of a FOLE in reversing PNAC. Methods: The effectiveness in reversing PNAC was evaluated in prospective cohort study of very preterm infants when compared to historical controls: twenty-six infants (27.0 ± 2.6 weeks GA; 724 ± 204 g) who developed cholestasis while receiving SLE were shifted to receive FOLE and were compared with 30 infants (27.3 ± 2.5 weeks GA 838 ± 277 g) who continued to receive SLE at diagnosis of cholestasis. Results: Time to reversal of cholestasis was the same in the two study groups (45 ± 21 vs 43 ± 32 days). Conclusions: FOLE does not seem to be superior to SLE in reversing cholestasis. Considering that definitive data on the actual efficacy of FOLE to reverse PNAC are lacking, larger randomized trials are required, mainly to asses if FOLE may have a role in PNAC prevention rather than PNAC treatment.

Original languageEnglish
Article number101
JournalItalian Journal of Pediatrics
Issue number1
Publication statusPublished - Aug 23 2018


  • Fish oil-based lipid emulsion
  • Parenteral nutrition-associated cholestasis
  • Preterm infants

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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