Olive Oil and Soybean 1 Oil Based Intravenous Lipid Emulsions, Liver Chemistry and Clinical Outcomes
Olive Oil and Soybean 1 Oil Based Intravenous Lipid Emulsions, Liver Biochemistry and Clinical Outcomes
Background: Intravenous lipid emulsions (IVLE) are an essential component of parenteral nutrition (PN). Omega-6 reducing strategies may improve outcomes, including reduced PN associated liver disease.
Objective: The primary objective was to compare serum alkaline phosphatase (ALP), among surgical and medical patients provided with either Intralipid or Clinoleic lipid emulsions.
Design: In this quasi-experimental study the medical records of surgical and medical adult patients were reviewed from 3 Canadian hospitals that received PN with either soybean oil (Intralipid) or predominantly olive oil (Clinoleic) based lipid emulsions for at least 7 consecutive days.
研究概览
地位
条件
详细说明
A few small studies have shown that a predominantly olive oil based IVLE is well tolerated and safe, however the clinical relevance of this IVLE is uncertain as no clear benefit in outcomes has been observed in small randomized clinical trials. Given the limited data available for the adult population reporting on the experience with olive oil based IVLE, we designed a quasi-experimental study to review our experience with Clinoleic compared to Intralipid. The primary objective was to compare the impact of Intralipid and Clinoleic IVLE on serum alkaline phosphatase (ALP), pre-PN to after one week of PN (i.e. between day 8 to 16 post-PN initiation), while controlling for the ordered lipid dosing. Secondary objectives were to assess if there were differences between the IVLEs on the remaining liver function tests, lipid dosing, incidence of infectious complications, length of stay in hospital and 30- day mortality.
This retrospective quasi-experimental chart review was conducted in 3 tertiary care hospitals in Calgary, AB between July 01, 2012 to June 30, 2013 and July 01, 2014 to June 30, 2015. Standard soybean oil-based therapy, Intralipid was the only available IVLE in Calgary, AB until July 2013, at which time predominantly olive oil Clinoleic was approved as an alternative in the hospital formulary, accounting for the dates chosen for the study. Ethics approval from the Conjoint Health Research and Ethics Board at the University of Calgary was obtained prior to the initiation of the study.
研究类型
注册 (实际的)
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- admitted to hospital who received PN with Intralipid or Clinoleic IVLEs for at least 7 consecutive days.
Exclusion Criteria:
- baseline liver disease
- home PN prior to admission
- ALP and total bilirubin (TB) not available within 3 days prior to PN start as well as between days 8 to 16 post PN start
- receipt of Diprivan 1%® (Propofol 116 - AstraZeneca Canada Inc., Mississauga, Canada) during PN support period
- enteral nutrition providing greater than 600 Kcal daily for longer than half of time period on PN
- oral intake of greater than 50% of hospital meal tray contents for longer than half of the PN support time period
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
---|
Intralipid
Standard soybean oil-based therapy
|
Clinoleic
Olive oil based therapy
|
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Serum ALP Level
大体时间:8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Serum ALT
大体时间:8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
Serum GGT
大体时间:8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
Serum TB
大体时间:8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
Serum BD
大体时间:8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
Serum TG
大体时间:8 to 16 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
8 to 16 days after PN initiation
|
IVLE prescriptions dosing
大体时间:Day 3 to 16 after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
Day 3 to 16 after PN initiation
|
All cause mortality
大体时间:By 30 days after PN initiation
|
Difference between Intralipid and Clinoleic groups
|
By 30 days after PN initiation
|
Length of hospital stay
大体时间:During PN Period
|
Difference between Intralipid and Clinoleic groups
|
During PN Period
|
Infectious complications incidence
大体时间:During PN Period
|
Difference between Intralipid and Clinoleic groups
|
During PN Period
|
合作者和调查者
调查人员
- 首席研究员:Maitreyi Raman、University of Calgary
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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