Abstract
Intestinal Failure-Associated Liver Disease (IFALD) presents significant challenges in pediatric patients on long-term parenteral nutrition (PN). CASE REPORT: We conducted a case series to evaluate safety and efficacy of administering higher dose (2 g/kg/day) Omegaven® (Fresenius Kabi AG, Bad Homburg, Germany), a fish oil-based lipid emulsion (FOLE), in pediatric patients with IFALD. Ten patients at Boston Children's Hospital were found to have received FOLE at 2 g/kg/day. Data was retrospectively collected from electronic health records, including demographics, laboratory values, and treatment outcomes. CONCLUSION: All patients using higher dose FOLE successfully transitioned to 20-hour PN cycles with FOLE 2 g/kg/day, meeting daily caloric requirements and preventing hypoglycemia. No adverse reactions were reported. For most patients, liver function markers remained within normal limits. Our findings suggest higher dose FOLE can facilitate PN cycling and promote growth. Further studies are warranted to validate these findings and establish optimal dosing for this patient population.