2017 - CIRTA


This page contains exclusive content for the member of the following sections: TTS, ITA. Log in to view.

2- Nutrition Management and Total Parenteral Nutrition

18.14 - Beneficial effects of enteral fat supplementation on essential fatty acid profiles of pediatric patients with intestinal failure

Presenter: Sivan, Kinberg, Bronx, United States
Authors: Sivan Kinberg, Susan Brodlie, Shelly Scheer, Maeghan Overley, Julie Khlevner, Esi Lamousé-Smith , Steven Lobritto, Mercedes Martinez

Beneficial effects of enteral fat supplementation on essential fatty acid profiles of pediatric patients with intestinal failure

Sivan Kinberg1, Susan Brodlie1, Shelly Scheer1, Maeghan Overley1, Julie Khlevner1, Esi Lamousé-Smith 1, Steven Lobritto1, Mercedes Martinez1.

1Pediatric Gastroenterology, Hepatology and Nutrition, Columbia University Medical Center, New York, NY, United States

Introduction: The soy-based lipid component of parenteral nutrition (PN) is a known contributing factor to intestinal failure associated liver disease (IFALD). Lipid minimization (LM) protocols have been established to prevent and/or reverse IFALD. Although effective in reducing hepatotoxicity, this practice predisposes to essential fatty acid (EFA) deficiency. We assessed the impact of enteral fat supplementation on EFA profiles in this vulnerable population.

Methods: A single-center, retrospective review revealed 39 patients with IF and available EFA profiles. We defined EFA deficiency as a triene:tetraene (tr:te) ratio of >0.05. Patients received 1-5 milliliters of a variety of enteral omega-6 fats, as tolerated. We trended EFA profiles 3-6 months after supplementation was initiated.

Results: Thirty-one patients were found to have EFA deficiency. Thirteen patients had received enteral fat supplementation and had complete data at follow-up. The mean age was 5.9 years (range 0-16), 6 were female and 82% had short bowel syndrome. The mean tr:te ratio at baseline was 0.169 and dropped to 0.076 after supplementation, representing significant improvement (p value=0.0006).

Conclusion: EFA deficiency can be significantly improved with enteral supplementation using a variety of omega-6 fats in IF patients requiring LM as part of PN management. Further multicenter prospective studies with larger sample size are needed to validate and optimize this approach.


Important Disclaimer

By viewing the material on this site you understand and accept that:

  1. The opinions and statements expressed on this site reflect the views of the author or authors and do not necessarily reflect those of The Transplantation Society and/or its Sections.
  2. The hosting of material on The Transplantation Society site does not signify endorsement of this material by The Transplantation Society and/or its Sections.
  3. The material is solely for educational purposes for qualified health care professionals.
  4. The Transplantation Society and/or its Sections are not liable for any decision made or action taken based on the information contained in the material on this site.
  5. The information cannot be used as a substitute for professional care.
  6. The information does not represent a standard of care.
  7. No physician-patient relationship is being established.

Social

Contact

Staff Directory
+1-514-874-1717
info@tts.org

Address

The Transplantation Society
International Headquarters
740 Notre-Dame Ouest
Suite 1245
Montréal, QC, H3C 3X6
Canada