Preterm infants of extreme low birth weight (ELBW, < 1000 gram birth weight) cannot
immediately be nourished with mother´s or formula milk and are typically dependent on
parenteral nutrition (PN) for a prolonged period of time. This puts them at risk for liver
complications of PN, namely parenteral nutrition associated cholestasis (PNAC).
Intravenous lipid emulsions (ILE) based on soy bean oil are standard of care for provision of
energy and essential fatty acids in preterm infants. However, they might be implicated in the
pathogenesis of PNAC.
ILEs based on pure fish oil are proposed for therapy of PNAC. Recently a lipid emulsion
containing 15 % fish oil together with soy bean, olive and MCT oil has become available in
Europe (SMOFLIPID®). Such a balanced lipid emulsion might be more favourable than the
standard soy bean oil emulsion (Intralipid®) concerning the development of PNAC. Furthermore
ILEs containing fish oil might exert a positive effect on neurodevelopment. However, there
are no data so far.
The study aims to evaluate the fish oil containing ILE "SMOFlipid®" for its protective effect
against PNAC in ELBW infants compared to standard treatment with the soy bean based ILE
"Intralipid®". Furthermore neurodevelopment at 12 and 24 months of corrected gestational age
will be investigated.