Research Article
Volume 11 Issue 4 - 2022
Safety and Efficacy of Intravenous Lipid Emulsion Containing Soyabean Oil, Medium Chain Triglycerides, Olive Oil, and Fish Oil (SMOF Lipid) vs. Conventional Lipid Emulsion: A Single-Center, Double Blind Randomized Controlled Trial in Neonates Requiring Parenteral Nutrition
Jay Shah1*, Shekhar Biswas2, Anirudh Ghai3 and Vishal Jain4
1DNB, Department of Pediatrics, Jaipur Golden Hospital, Rohini, New Delhi, India
2Senior Consultant, Department of Pediatrics, Jaipur Golden Hospital, Rohini, New Delhi, India
3Senior Consultant and HOD, Department of Pediatrics, Jaipur Golden Hospital, Rohini, New Delhi, India
4Neonatologist, Jaipur Golden Hospital, Rohini, New Delhi, India
*Corresponding Author: Jay Shah, DNB, Department of Pediatrics, Jaipur Golden Hospital, Rohini, New Delhi and Assistant Professor, Department of Pediatrics, Pramukhswami Medical College, Bhaikaka University, Karamsad, Gujarat, India.
Received: February 17, 2022; Published: March 11, 2022


Background: Intravenous lipid emulsions are an integral part of the PN in neonates. Because of their high content of PUFAs and limited content of α­tocopherol, they deplete antioxidant defences. The need for more appropriate lipid emulsions in neonatal care is well recognized.

Aims and Objectives: To evaluate the safety and effects of two different intravenous lipid emulsion in neonates requiring total parenteral nutrition.

Materials and Methods This study was a single center, double blind randomized controlled trial conducted in NICU of a tertiary care hospital, from December 2017 to November 2018. Eighty premature newborns of < 34 weeks gestational age were randomized equally to two groups - SMOF lipid and Intralipid. Anthropometric measurements and biochemical variables including serum triglycerides, total and direct bilirubin, SGOT, SGPT, GGT and BUN were assessed in laboratory at 7 and 14 days.

Results: The two groups were comparable at baseline with regards to gestational age, weight, length, and head circumference. Comparison between SMOF group and IL group for anthropometric parameters, Duration of NICU stay and number of days taken to reach birth weight showed that both groups were comparable (p > 0.05). Triglycerides, SGOT, SGPT, GGT, BUN were significantly higher in IL group than SMOF group at 7 (p < 0.05) and 14 (p < 0.05) days.

Conclusion: SMOF is safe and well tolerated in preterm neonates requiring parenteral nutritionand using of SMOF lipid might be advantageous with regard to better biochemical parameters compared to conventional Intralipid.


Keywords: Parenteral Nutrition; Preterm; SMOF Lipid; Intralipid


  1. Shulman RJ and Phillips S. “Parenteral nutrition in infants and children”. Journal of Pediatric Gastroenterology and Nutrition 5 (2003): 587-607.
  2. Goulet O and Ruemmele F. “Causes and management of intestinal failure in children”. Gastroenterology2 (2006): S16-S28.
  3. Koletzko B., et al. “Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), supported by the European Society of Paediatric Research (ESPR)”. Journal of Pediatric Gastroenterology and Nutrition 2 (2005): S1-S87.
  4. Krohn K and Koletzko B. “Parenteral lipid emulsions in paediatrics”. Current Opinion in Clinical Nutrition and Metabolic Care 3 (2006): 319-323.
  5. Innis SM. “Fatty acids and early human development”. Early Human Development 12 (2007): 761-766.
  6. Lee EJ., et al. “Essential fatty acid deficiency in parenterally fed preterm infants”. Journal of Paediatrics and Child Health 1 (1993): 51-55.
  7. Cetin I and Koletzko B. “Long-chain omega-3 fatty acid supply in pregnancy and lactation”. Current Opinion in Clinical Nutrition and Metabolic Care 3 (2008): 297-302.
  8. Sala-Vila A., et al. “Olive oil in parenteral nutrition”. Current Opinion in Clinical Nutrition and Metabolic Care 10 (2007): 165-174.
  9. Koletzko B and Goulet O. “Fish oil containing intravenous lipid emulsions in parenteral nutrition-associated cholestatic liver disease”. Current Opinion in Clinical Nutrition and Metabolic Care3 (2010): 321-326.
  10. Mayer K., et al. “Fish oil in the critically ill: from experimental to clinical data”. Current Opinion in Clinical Nutrition and Metabolic Care 2 (2006): 140-148.
  11. Mertes N., et al. “Safety and efficacy of a new parenteral lipid emulsion (SMOF lipid) in surgical patients: a randomized, double-blind, multicenter study”. Annals of Nutrition and Metabolism 3 (2006): 253-259.
  12. Rayyan M., et al. “Short-Term Use of Parenteral Nutrition with a Lipid Emulsion Containing a Mixture of Soybean Oil, Olive Oil, Medium-Chain Triglycerides, and Fish Oil: A Randomized Double-Blind Study in Preterm Infants”. Journal of Parenteral and Enteral Nutrition 1 (2012): 81S-94S.
  13. Uthaya S., et al. “Nutritional Evaluation and Optimisation in Neonates: a randomized, double-blind controlled trial of amino acid regimen and intravenous lipid composition in preterm parenteral nutrition”. American Journal of Clinical Nutrition 6 (2016): 1443-1452.
  14. Deshpande G., et al. “Fish Oil (SMOF lipid) and olive oil lipid (Clinoleic) in very preterm neonates”. Journal of Pediatric Gastroenterology and Nutrition 2 (2014): 177-182.
  15. Repa A., et al. “A Mixed Lipid Emulsion for Prevention of Parenteral Nutrition Associated Cholestasis in Extremely Low Birth Weight Infants: A Randomized Clinical Trial”. The Journal of Pediatrics 194 (2018): 87-93.
  16. Hanson C., et al. “Implementation, process, and outcomes of nutrition best practices for infants < 1500g”. Nutrition in Clinical Practice 5 (2011): 614-624.
  17. Kapoor V., et al. “Alternative lipid emulsions versus pure soy oil based lipid emulsions for parenterally fed preterm infants”. Cochrane Database of Systematic Reviews 12 (2015): CD009172.
  18. Tomsits E., et al. “Safety and efficacy of a lipid emulsion containing a mixture of soybean oil, medium chain triglycerides, olive oil and fish oil: a randomized, double blind clinical trial in premature infants requiring parenteral nutrition”. Journal of Pediatric Gastroenterology and Nutrition4 (2010): 514-521.
  19. Finn KL., et al. “Impact of Providing a Combination Lipid Emulsion Compared with a Standard Soybean Oil Lipid Emulsion in Children Receiving Parenteral Nutrition: A Systematic Review and Meta-Analysis”. Journal of Parenteral and Enteral Nutrition 6 (2015): 656-667.
  20. Klek S., et al. “Four-week parenteral nutrition using a third generation lipid emulsion (SMOF lipid) - A double-blind, randomised, multicenter study in adults”. Clinical Nutrition Journal2 (2013): 224-231.
  21. Goulet O., et al. “A new Intravenous fat emulsion containing soybean oil, medium chain triglycerides, olive oil and fish oil: a single center double blind randomized study on efficacy and safety in pediatric patients receiving home parenteral nutrition”. Journal of Parenteral and Enteral Nutrition 5 (2010): 485-495.
  22. Gawecka A., et al. “Tolerance of two lipid emulsions used in parenterally-fed premature infants - a comparative study”. Medycyna Wieku Rozwojowego 3 (2008): 782-788.
  23. Zhao Y., et al. “Safety and efficacy of parenteral fish oil-containing lipid emulsions in premature neonates”. Journal of Pediatric Gastroenterology and Nutrition6 (2015): 708-716.
  24. Vlaardingerbroek H and van Goudoever JB. “Intravenous lipids in preterm infants: impact on laboratory and clinical outcomes and long-term consequences”. World Review of Nutrition and Dietetics 112 (2015): 71-80.
Citation: Jay Shah., et al. “Safety and Efficacy of Intravenous Lipid Emulsion Containing Soyabean Oil, Medium Chain Triglycerides, Olive Oil, and Fish Oil (SMOF Lipid) vs. Conventional Lipid Emulsion: A Single-Center, Double Blind Randomized Controlled Trial in Neonates Requiring Parenteral Nutrition”. EC Paediatrics 11.4 (2022): 13-22.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

January Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

ECronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before February 10, 2023.

Certificate of Publication

ECronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

ECronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.