Research Showcase Abstracts
Explore abstracts from CFDR’s annual research showcase at the DC Conference.
Year
2018
Language
English
Title
A description of liver functions tests amongst adult patients in the British Columbia Home Parenteral Nutrition (BC HPN) Program who have changed from a soybean oil emulsion to a mixed-lipid emulsion
Introduction/Purpose
Prolonged use of soybean-oil (SO) based lipid emulsions in parenteral nutrition (PN) may contribute to the development of PN-associated liver disease (PNALD). Current research suggests a role for mixed-lipid emulsions in preventing, treating, or managing PNALD in acute-care settings. The use of mixedlipid emulsions and their effects on liver function tests (LFTs) in adults receiving home PN (HPN) has not been widely studied.
Objective(s)/Process or Summary of Content
To describe demographic and clinical characteristics of BC HPN patients who have transitioned from Intralipid®, a SO-lipid emulsion, to MOFlipid®, a mixed-oil emulsion, and to describe any changes with regards to LFTs before and after transition to SMOFlipid®.
Method(s)/Systemic Approach Used
A retrospective chart review was completed for BC HPN patients who transitioned from Intralipid® to SMOFlipid® and were active between January 1/13 and October 31/17. Data collected included demographic and clinical information, HPN prescription details, and monthly measurements of FTs before and after lipid transition. Data was analyzed using descriptive statistics.
Results/Conclusions
19 patients constituted the study group; 6 could not be analyzed, and 3 were outliers, leaving 10 for analysis. The most frequent indication for HPN was short bowel syndrome (SBS) (90%, n=9). 50% of participants showed signs of liver injury on Intralipid®. After transition to SMOFlipid®, 50% of the study population had decreases in their mean value of all four LFTs, however the degree of change varied.
Conclusions(s)/Recommendations
Overall, LFTs declined after transition to SMOFlipid®. These findings are consistent with studies observing effects of SMOFlipid® on LFTs; however, most compare SO-based and mixed-lipid intravenous lipid emulsions (ILEs) in acute or surgical settings.
Significance to Dietetics
No other studies have looked at a transition from Intralipid® to SMOFlipid® in the HPN population. Further understanding of the long-term impact of mixed ILEs will help to inform whether SMOFlipid® should be considered for primary prevention of PNALD for BC HPN patients.
