Changes of Total Plasma Triglycerides in Neonates Treated With Intralipid: A Pilot Study

The current scientific literature states that Intralipid 10% emulsion has a higher ratio of phospholipids to triglycerides, and contains more lypozomal phospholipids as compared to Intralipid 20% and Intralipid 30%, so it causes higher plasma concentrations of triglycerides, cholesterol and phospholipids (1, 2). It should be noted that serum triglycerides concentration is used as a marker for lipid tolerance and predicting the probability of complications involved with the administration of Intralipid 10%. In view of the fact that Intralipid 10% emulsion is the only currently available Intralipid in Iran, and also used for years, is known to have no significant side effects, we conducted a before and after descriptive, observational study on 20 newborns (10 females and 10 males) hospitalized in NICU of Valiasr hospital, Tehran University of Medical Sciences, that required total intravenous nutrition, and evaluated the effects of Intralipid 10% on neonates’ total plasma triglycerides before TPN and once the dose of Intralipid reached 2.5 g/kg/day. In the first step total plasma triglycerides level was measured. Then continuous daily infusion of Intralipid 10% with 0.5 g/kg/day dose was started increasing daily 0.5 g/kg until enteral nutrition was able to provide approximately 100 to 110 kcal for kg body weight. The outcome was total plasma triglycerides levels higher than 200 mg/dL in newborns receiving intravenous Intralipid 10% nutrition. Heparin was administered routinely with parenteral nutrition; heparin can theoretically release lipase lipoprotein from endothelial cells that may accelerate clearance of lipids from plasma.