Objective: Concerns have been raised that early introduction of intravenous lipid to preterm infants may increase the risk of death or CLD. The aim of this study was to assess the effect of early (< 5 days) vs. late(> 5 days) introduction of intravenous lipid on these outcomes.
Methods: Meta-analyses of all randomised controlled trials(RCT's) were performed after searching personal files, Medline, Embase and Science Citation Index. To identify suitable RCT's, two independent researchers used key words: intravenous fat emulsions and/or lipids; infant - premature and/or low birth weight; CLD, bronchopulmonary dysplasia or mortality; RCT. Data were independently abstracted by the two researchers and any discrepancy was resolved by consensus. Revman® was used to calculate relative risk (RR) with 95% confidence intervals (CI) for death, CLD at 28 days of life and CLD at 36 weeks corrected age.
Results: Six RCT's were identified including 522 infants. There was some variation between the RCT's in the timing of early (days 1 to 5) and late (days 5 to 14) introduction of intravenous lipid. Results of meta-analyses are shown in the table below.
Conclusion: To date 522 preterm infants have been enrolled in RCT's designed to assess the effect of early vs. late introduction of intravenous lipid. The RR's of 1.01 - 1.03 indicate no effect (or trend) on the incidence of death or CLD.
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Fox, G., Wilson, D. & Ohlsson, A. Effect of Early Vs. Late Introduction of Intravenous Lipid To Preterm Infants on Death and Chronic Lung Disease (CLD) - Results of Meta-Analyses † 1250. Pediatr Res 43 (Suppl 4), 214 (1998). https://doi.org/10.1203/00006450-199804001-01271
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DOI: https://doi.org/10.1203/00006450-199804001-01271