JPEN. Journal of parenteral and enteral nutrition · 2025
Association between mixed oil lipid emulsions and all-cause infections relative to soybean oil lipid emulsions in hospitalized adults: A retrospective cohort study.
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Unhapipatpong Chanita, Wang Christopher, Schwenger Katherine J P, Zirabamuzaale Jackie, Albadrani Ahmed, Showair Mishal Al, Floro Geraldine C, Kim Patricia, Santos Lilian, Ghorbani Yasaman, Liu Yuqing, Lou Wendy, Allard Johane P
Аннотация
BACKGROUND: Intravenous lipid emulsions are a key component of parenteral nutrition, and their fatty acid compositions may influence immune responses and clinical outcomes.
METHODS: This retrospective cohort study conducted from January 2020 to December 2022 compared clinical outcomes of hospitalized non-critical care patients receiving parenteral nutrition with either mixed oil or soybean oil lipid emulsions for at least 48 h. The primary outcome was a composite of the presence of pneumonia, urinary tract infection, or an intra-abdominal collection diagnosed within 14 days of initiating parenteral nutrition. Secondary outcomes included catheter-related bloodstream infection, length of hospital stay, duration of antibiotic therapy, in-hospital mortality, and changes in the aspartate transaminase (AST)/alanine transaminase (ALT) ratio over time.
RESULTS: Among 266 patients (mixed oil lipid emulsion: n = 130; soybean oil lipid emulsion: n = 136) there was no statistically significant difference in all-cause infections (P = 0.21). In patients receiving lipid emulsions for >7 days, the use of mixed oil lipid emulsions was associated with a shorter median antibiotic duration (4 days: interquartile range [IQR] 1-8.5 vs 7 days: IQR 5-10; P = 0.04). Additionally, patients who received mixed oil emulsions for >7 days had a significantly greater change in the AST/alkaline phosphatase ratio after 14 days compared with the soybean oil group (β = -0.51; P = 0.02).
CONCLUSION: Although there was no difference in all-cause infections between types of lipid emulsions, mixed oil lipid emulsions were associated with shorter antibiotic use and lower AST/ALT ratio in hospitalized, non-critical care patients receiving parenteral nutrition for >7 days.
METHODS: This retrospective cohort study conducted from January 2020 to December 2022 compared clinical outcomes of hospitalized non-critical care patients receiving parenteral nutrition with either mixed oil or soybean oil lipid emulsions for at least 48 h. The primary outcome was a composite of the presence of pneumonia, urinary tract infection, or an intra-abdominal collection diagnosed within 14 days of initiating parenteral nutrition. Secondary outcomes included catheter-related bloodstream infection, length of hospital stay, duration of antibiotic therapy, in-hospital mortality, and changes in the aspartate transaminase (AST)/alanine transaminase (ALT) ratio over time.
RESULTS: Among 266 patients (mixed oil lipid emulsion: n = 130; soybean oil lipid emulsion: n = 136) there was no statistically significant difference in all-cause infections (P = 0.21). In patients receiving lipid emulsions for >7 days, the use of mixed oil lipid emulsions was associated with a shorter median antibiotic duration (4 days: interquartile range [IQR] 1-8.5 vs 7 days: IQR 5-10; P = 0.04). Additionally, patients who received mixed oil emulsions for >7 days had a significantly greater change in the AST/alkaline phosphatase ratio after 14 days compared with the soybean oil group (β = -0.51; P = 0.02).
CONCLUSION: Although there was no difference in all-cause infections between types of lipid emulsions, mixed oil lipid emulsions were associated with shorter antibiotic use and lower AST/ALT ratio in hospitalized, non-critical care patients receiving parenteral nutrition for >7 days.