Oleh Admin Kalbe Medical pada March 10, 2017 07:30

Emulsi Lemak Olive Oil vs Soybean Oil pada Fungsi Liver Bayi Prematur

Perkembangan nutrisi parenteral saat ini dapat memperbaiki prognosis pada extremely premature infants. Namun, disfungsi hepatobilier secara bermakna merupakan komplikasi yang mengancam jiwa yang berhubungan dengan nutrisi parenteral. Kolestasis dapat berkembang sekitar 40-60% pada bayi dan meningkat sampai 85% pada neonatus yang diberi nutrisi parenteral jangka panjang. Kejadian disfungsi liver terjadi 14 hari setelah pemberian nutrisi parenteral pada neonatus, dan meningkat sampai 25% pada anak dengan parenteral nutrition-associated cholestasis (PNAC) dan dapat berkembang menjadi sirosis bilier dan gagal hati sampai membutuhkan transplantasi.

Perkembangan kolestasis dihubungkan dengan beberapa faktor. Pada neonatus, dihubungkan dengan prematuritas, sepsis berulang (khususnya sepsis yang disebabkan oleh kateter), penggunaan emulsi lemak yang berbasis soybean, dan gangguan asupan enteral. Hubungan kolestasis dengan infus emulsi lemak telah dipelajari dengan baik. Pada dewasa, kolestasis terjadi jika dosis pemberian lemak parenteral > 1 g/kgBB/hari, begitu juga pada anak tergantung dari tipe lemak dan metode pemberiannya. Peranan lemak parenteral terhadap terjadinya PNAC sering diperdebatkan. Masing-masing emulsi lemak mempunyai kelebihan dan kekurangan. Oleh karena itu, dilakukan penelitian  ini dengan tujuan untuk membandingkan pemberian emulsi lemak yang berbasis olive oil dengan soybean oil pada fungsi liver bayi prematur.

Penelitian acak, tersamar ganda dengan subjek sebanyak 103 bayi prematur yang kemudian dibagi menjadi 2 kelompok, yaitu kelompok 1 mendapatkan emulsi lemak yang berbasis soybean oil (n=51) dan kelompok 2 mendapatkan emulsi lemak yang berbasis olive oil (n=52). Parameter primer yang dinilai adalah fungsi kimia liver, sedangkan parameter sekunder yang dinilai adalah komposisi asam empedu plasma. Hasilnya menunjukkan pada kelompok 1 mengalami peningkatan serum bilirubin direk secara bermakna dibandingkan dengan kelompok 2 setelah 7 hari pemberian. Sedangkan asam empedu meningkat jumlahnya pada kedua kelompok. Hal ini menunjukkan bahwa penggunaan olive oil dan soybean oil jangka panjang (7 hari) pada bayi prematur aman dan tidak menyebabkan kolestasis. (LAI)

Image : Ilustrasi
Referensi:
1.Wang Y, Zhou KJ, Tang QY, Hong L, Feng Y, Lu LN, et al. Effect of an olive oil–based lipid emulsion compared with a soybean oil–based lipid emulsion on liver chemistry and bile acid composition in preterm infants receiving parenteral nutrition: A double-blind, randomized trial. JPEN J Parenter Enteral Nutr. 2016;40(6):842-50. doi: 10.1177/0148607114566853.  
2.Saayman BD. The use of alternative lipid emulsions in paediatric and     neonatal parenteral nutrition. S Afr J Clin Nutr. 2011;24(3):32-4.

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