Displacement of Bilirubin from Albumin by Omegaven and Intralipid

Intralipid, a soybean oil-based fat emulsion, is the only FDA-approved lipid source for neonatal parenteral nutrition, but it increases unbound free fatty acids (FFAu), which can displace bilirubin from albumin and elevate the risk of bilirubin-induced neurologic dysfunction (BIND). Omegaven, a fish oil-based alternative, exhibits hepatoprotective properties; however, its effect on bilirubin displacement is less well understood.