The effect of different intravenous lipids on free bilirubin levels in premature infants

Background Intravenous lipid emulsions are commonly used as a part of parenteral nutrition in premature infants. The potential bilirubin-displacing effects of high free fatty acid (FFA) levels during lipid infusions are known. Levels of free bilirubin (FB) predict the risk of bilirubin neurotoxicity more accurately than indirect serum bilirubin levels. In the present study, we decided to compare the effect of two different lipid solutions on free bilirubin and free fatty acids levels in premature infants. Methods Infants were grouped into two groups according to intravenous lipid preparations: Infants in Group 1 received lipid emulsion containing olive oil + soybean oil and Group 2 received containing olive oil + soybean oil + fish oil. The blood samples were gained when lipid intake was 3.5 g/kg/day and FFA and FB levels were analyzed. Results Serum FFA and FB levels were similar in groups ( p = 0.26 and 0.69 respectively). There were significant correlation between serum FFA and FB levels in Group 1 ( r = 0.74, p < 0.001) and in Group 2 ( r = 0.92, p < 0.001). Conclusion Both lipid preparations seem to have similar effects on free bilirubin and free fatty acid levels in premature newborns.