Soybean oil is associated with a near four-fold increase in the death rate in infants with parenteral nutrition-associated liver disease

This study was published in the Annals of Surgery 2009 Sep;250(3):395-402

Study title and authors:
Parenteral fish oil improves outcomes in patients with parenteral nutrition-associated liver injury.

Puder M, Valim C, Meisel JA, Le HD, de Meijer VE, Robinson EM, Zhou J, Duggan C, Gura KM.
Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA, USA. mark.puder@childrens.harvard.edu

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/19661785?dopt=AbstractPlus

This study compared the safety and efficacy between a fish oil-based intravenous lipid emulsion and a soybean oil-based intravenous lipid emulsion in the treatment of parenteral nutrition-associated liver disease.

Parenteral feeding is the intravenous administration of nutrients to patients who cannot support their nutritional needs because of intestinal failure. Prolonged parenteral feeding may lead to health complications such as: Steatosis, steatohepatitis, cholestasis, fibrosis, micronodular cirrhosis, phospholipidosis, biliary sludge and cholelithiasis.

The study included:
(i) 42 infants with short bowel syndrome who received fish oil-based intravenous lipid emulsion after they had developed cholestasis (cholestasis is a condition where bile cannot flow from the liver to the small intestine) while receiving soybean oil-based intravenous lipid emulsion. (Fish oil group).
(ii) 49 infants with short bowel syndrome and cholestasis whose who continued to receive soybean oil-based intravenous lipid emulsion only. (Soybean oil group).

The study found:
(a) Three deaths and one liver transplantation occurred in the fish oil group, compared with 12 deaths and six transplants in the soybean oil group.
(b) Among survivors not transplanted during parenteral nutrition, cholestasis reversed while receiving parenteral nutrition in 19 of 38 patients in the fish oil group versus two of 36 patients in the soybean oil group.

The study shows that soybean oil is associated with a nearly four-fold increase in the death rate compared to fish oil in infants with parenteral nutrition-associated liver disease.