Fish oil emulsion for reversal of intestinal failure-associated liver disease in preterm infants: Three case reports and review of literature

Table 1 Clinical characteristics of 3 cases

		Case 1	Case 2	Case 3
Sex		Male	Female	Male
Gestational age		31 weeks	35 weeks	36+2 weeks
Birth weight		1320 g	920 g	2750 g
Condition		Necrotizing enterocolitis, septic shock, meconium intestinal obstruction	Hemodynamically significant patent ductus arteriosus, heart failure, neonatal pneumonia	Complex small bowel atresia, neonatal sepsis
Medications that may cause cholestasis		Cefoperazone-sulbactam, vancomycin	Cefoperazone-sulbactam, meropenem, ibuprofen	Cefoperazone-sulbactam, meropenem
Direct bilirubin (μmol/L)	At FO-ILE start	229.2	191.9	38.4
	Peak value	229.2	191.9	356
	At FO-ILE cessation	89.9	19.9	30.7
Peak total bilirubin (μmol/L)		300.9	298.3	451.9
Duration of PN before FO-ILE		69 days	22 days	42 days
Duration of FO-ILE therapy		29 days	47 days	63 days
Duration of PN after FO-ILE		0 days	0 days	0 days
Duration of PN		98 days	69 days	105 days
Peak triglyceride level (borderline high: 1.7-2.25 mmol/L)		2.00 mmol/L	2.06 mmol/L	3.39 mmol/L
Peak prothrombin time value (9.0-15.0 seconds)		14.7 seconds	15.7 seconds	16.5 seconds
Peak APTT value (18.3-38.3 seconds)		45.9 seconds	48.3 seconds	37.2 seconds
Peak INR value (0.8-1.5)		1.43	1.53	1.65
Triene:Tetraene		Normal	Normal	Normal
Outcome		Resolved	Resolved	Resolved

FO-ILE: Fish oil lipid emulsion; PN: Parenteral nutrition; APTT: Activated partial thromboplastin time; INR: International normalized ratio.