INTRODUCTION: The using of lipid emulsion in TPN for preterm infants can affect clinical outcomes.
Objective: to assess the health outcomes and potential adverse effects stemming from the exclusion of SMOFlipid emulsion in TPN, specifically focusing on the incidence of neonatal sepsis, length of stay (LOS) in the Neonatal Intensive Care Unit (NICU), and the associated economic implications from the perspective of healthcare providers in Egypt.
METHODS: A record-based retrospective cohort study was conducted in 2021. We collected data from the neonatal intensive care unit (NICU) of Alexandria University Pediatric Hospital, Egypt, who received TPN. The collected data included gestational age, birth weight, sex, diagnosis of sepsis, LOS in the NICU and type of TPN. Our sample comprised 103 newborns who received TPN with SMOFlipid and 104 newborns who received TPN without SMOFlipid. Balance of baseline characteristics of the study groups was achieved using propensity score. Odds ratios were estimated using logistic regression, and the statistical significance was set at < 0.05.
RESULTS: Compared with TPN without lipids, the use of SMOFlipid was associated with an observed reduction in the risk of sepsis (OR = 0.47, 95% CI: 0.22 - 1.03) and difference in the mean reduction in hospital stay (4.12 days, p = 0.08). Moreover, using SMOFlipid was associated with a significant mean reduction in cost by 6,396 EGP (95% CI: 1,491 - 11,546 EGP).
CONCLUSION: The integration of SMOFlipid into TPN for preterm infants is associated with decreased incidence of sepsis, reduced NICU stay, and significant cost savings, warranting consideration for standard care practices.