Summary of findings 4. Alternative lipid emulsion (LE) compared to another alternative‐LE for parenterally fed preterm infants.
| Alternative‐LE compared to another alternative‐LE for parenterally fed preterm infants | |||||
| Patient or population: parenterally fed preterm infants Settings: neonatal intensive care unit Intervention: alternative‐LE Comparison: another alternative‐LE | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Other alternative‐LE | Alternative‐LE | ||||
|
Growth rate – MS‐LE vs OS‐LE |
— | The mean rate of weight gain in the intervention groups was 1.33 g/kg/day lower (7.36 lower to 4.7 higher) | — | 59 (1 study) | ⊕⊕⊝⊝ Lowa,b |
|
PNALD/cholestasis (conjugated bilirubin ≥ 2 mg/dL) – MS‐LE vs OS‐LE |
Study population | RR 2.9 (0.12 to 68.5) | 59 (1 study) | ⊕⊕⊝⊝ Lowa,b | |
| 0 per 1000 | 0 per 1000 (0 to 0) | ||||
|
Death before discharge – MS‐LE vs OS‐LE |
See comment | See comment | Not estimable | 60 (1 study) | No events in either group |
|
CLD (oxygen requirement at 36 weeks' postmenstrual age) – MS‐LE vs OS‐LE |
Study population | RR 0.77 (0.23 to 2.6) | 59 (1 study) | ⊕⊕⊝⊝ Lowa,b | |
| 172 per 1000 | 133 per 1000 (40 to 448) | ||||
|
Any sepsis (clinical or culture positive (or both)) – MS‐LE vs OS‐LE |
Study population | RR 1.93 (0.65 to 5.73) | 59 (1 study) | ⊕⊕⊝⊝ Lowa,b | |
| 138 per 1000 | 266 per 1000 (90 to 790) | ||||
|
Conjugated bilirubin levels – MS‐LE vs OS‐LE |
— | The mean conjugated bilirubin levels in the intervention groups was 2.91 µmol/L lower (6.87 lower to 1.05 higher) | — | 59 (1 study) | ⊕⊕⊝⊝ Lowa,b |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; CLD: chronic lung disease; LE: lipid emulsion; MS‐LE: medium‐chain triglyceride‐soybean oil‐lipid‐based emulsion; OS‐LE: olive oil‐soybean oil‐based lipid emulsion; PNALD: parenteral nutrition‐associated liver disease; RR: risk ratio. | |||||
| GRADE Working Group Grades of Evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | |||||
aDowngraded by one level as optimal information size not reached. bDowngraded by one level as the CI crossed the null effect and the limit of appreciable harm or benefit (0.75 or 1.25); or crossed limit of clinically appreciable harm or benefit in a continuous outcome (author consensus).