Soy oil based versus alternative lipid emulsions for parenterally fed preterm infants

Abstract

: This is the protocol for a review and there is no abstract. The objectives are as follows:Primary objectives: To compare the effects of soybean oil based lipid emulsions (SO-LE) versus alternative LE (olive oil based LE (OO-LE), medium chain triglyceride (MCT) oil based LE, structured LE, fish oil based LE or multi-combination LE) on: a) death, b) physical growth, c) chronic lung disease, and d) long term neuro-developmental outcomes in parenterally fed preterm infants. We would like to do separate comparisons for SO-LE and each of the different alternatives wherever the studies are available.Each available lipid emulsion type will be compared separately with SO-LE giving us five comparison groups: SO-LE versus OO-LE; SO-LE versus MCT-LE (pure MCT-LE and mixed MCT/LCT-LE); SO-LE versus structured lipids (structured MCT/LCT-LE); SO-LE versus FO-LE; SO-LE versus multi-combination LE. We would also consider studies which compare one non-soy alternative to another as a separate analysis, if feasible.Secondary objectives: To compare the effects of SO-LE versus alternative LE (OO-LE, MCT-LE, structured LE, FO-LE or multi-LE) on morbidities associated with prematurity and PNALD in parenterally fed preterm infants.Subgroup analysis will be performed based on: a) population type {gestational age (< 30 weeks, ? 30 weeks); gender; birth weight (? 1000 g, > 1000g); congenital malformations} and b) intervention type, early (? 3 days) versus late (4 to 7 days) introduction of LE; low dose (? 2 g/kg/day) versus high dose LE (> 2 g/kg/day); maximum dose from day 1 versus gradual increment of LE