Efectividad y seguridad de las emulsiones de pescado en la colestasis asociada a nutrición parenteral en neonatos

Abstract

Liver damage associated with parenteral nutrition is a lethal complication in patients with prolonged parenteral nutrition. Its etiology is not clear yet, and it is believed that the traditional lipid emulsions based on soybean oil may contribute to its genesis. Recently the modification of fatty acid content of traditional lipid emulsions of omega-6 to omega-3 rich is postulated as promising therapy in children with PNALD. We conducted a systematic literature search in Pubmed and Cochrane were selected clinical trials and prospective cohort studies. SIGN methodology will be used for rating and evaluation studies of the level of recommendation based on evidence. The meta-analysis carried out two articles included prospective cohort of the Boston group for the main outcome variable considered: time to reverse cholestasis. Patients receiving lipid emulsions of fish and cholestasis regressed significantly faster than those who received soybean emulsions (HR = 10.3, CI 95%: 3.7,29,0, fixed effects), lower mortality and less need for transplantation liver. Its use is not associated with fatty acid deficiency, hypertriglyceridemia, coagulopathy, or stunting. It was noticed a correlation between the decrease in triglyceride levels and increased levels of albumin, suggesting a nutritional benefit in patients treated with infusions of lipids in fish.