EFFECT OF FISH-OIL ENRICHED INTRAVENOUS LIPID EMULSION ON SYSTEMIC INFLAMMATORY RESPONSE SYNDROME IN CHILDREN AFTER SMALL INTESTINAL SURGERY
Khadijah Rizky Sumitro,Meta Herdiana Hanindita,Nur Aisiyah Widjaja,Siti Nurul Hidayati,Roedi Irawan,Boerhan Hidayat
Department of Child Health Faculty of Medicine Universitas Airlangga Dr Soetomo Hospital Surabaya Indonesia
Background : Intravenous lipid emulsions (IVLE) is one of the composition of the parenteral nutrition (PN) that recommended in children who cannot meet their caloric requirements especially after small intestinal surgery and differentiated by their inflammatory effects. The first generation IVLE is proinflammatory, the second and the third are inflammatory neutral, while the fourth (fish-oil enriched) is anti-inflammatory. Until now, there is limited information about the effect of these IVLEs on the inflammation response in children after small intestinal surgery. The aim of this study is to investigate the effect of fish-oil enriched IVLE on Systemic Inflammatory Response Syndrome (SIRS) in children after small intestinal surgery.
Material : A retrospective study using medical record was undertaken in children after small intestinal surgery admitted Dr. Soetomo Hospital, Surabaya in 2016-2017. Children with duodenal and jejunoileal atresia who had PN for at least three days were included. The types of IVLE used are the first and the fourth generation. Incomplete data was an exclusion criteria. Definition of SIRS was based on International Pediatric Sepsis Consensus Conference in 2005. Statistical analysis was performed by using the Fisher’s exact test with P<0.05 being considered significant.
Results : A total of 38 children underwent small intestinal surgery during this study period, but only 21 children (13/21 boys) included. There were 10/21 children received the first generation IVLE and 9/21 received the fourth while 2/21 received no IVLE. Median duration of IVLE was 8 days. Median dose of IVLE was 1.8 g/kg/day. SIRS was significantly more common in the first generation and no IVLE compared with the fourth generation (OR 17.5 95% CI 1.97 to 155.59; P=0.009).
Conclusions : Children who received the fish-oil enriched IVLE have a lower rate of SIRS than the first generation and no IVLE.
Keywords: small intestinal surgery intravenous lipid emulsion SIRS fish oil
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