Standard Lipid Therapy vs IVFE Minimization for Prevention of PNALD

Exclusion Criteria

• •weight \<1 kg
• •metabolic pathway defect which is associated with liver dysfunction in the neonatal period, including: hereditary fructose intolerance, galactosemia due to transferase deficiency and neonatal tyrosinemia, and/or disorder of lipid metabolism
• •hepatic insufficiency as documented by either a biopsy with cirrhosis and/or marked aberration in synthetic function
• •renal failure
• •primary or secondary liver disease, regardless of liver function (includes hepatitis)
• •use of extracorporeal membrane oxygenation (ECMO)
• •suspected congenital obstruction of the hepatobiliary tree
• •documented active infection which may be communicable, including infections hepatitis or HIV
• •previous receipt of choleretic agents
• •currently receiving phenobarbital or other barbiturates
• •history of PNAC
• •direct bilirubin \>=2 mg/dL at time of enrollment
• •congenital or acquired anomaly which will require major cardiovascular surgery
• •major congenital or chromosomal anomaly
• •hypoxic ischemic encephalopathy
• •congenital defect of the brain
• •major seizure disorder