Newer concepts of nutrition by the intravenous route

Fat emulsions for complete intravenous nutrition

“…For long-term intravenous administration of fat, it is necessary to know that quantities corresponding to the caloric requirement are without toxic effects. Long-term infusions of cottonseed oil emulsions in man and in the dog have been stated to cause anorexia with loss of weight, vomiting, gastro-intestinal bleeding, hyperlipaemia, anaemia, thrombocytopenia and prolonged coagulation and prothrombin times (Artz, 1959;Preston & Henegar, 1959;Werr & Preston, 1959;Cohn et al, 1960). The anaemia is regarded as haemolytic (Loewy et al, 1943;Levenson, Upjohn & Sheehy, 1957;Artz, 1959;Alexander & Zieve, 1961).…”

“…Long-term infusions of cottonseed oil emulsions in man and in the dog have been stated to cause anorexia with loss of weight, vomiting, gastro-intestinal bleeding, hyperlipaemia, anaemia, thrombocytopenia and prolonged coagulation and prothrombin times (Artz, 1959;Preston & Henegar, 1959;Werr & Preston, 1959;Cohn et al, 1960). The anaemia is regarded as haemolytic (Loewy et al, 1943;Levenson, Upjohn & Sheehy, 1957;Artz, 1959;Alexander & Zieve, 1961). Liver damage and spontaneous bleeding may also occur (Artz, 1959;Cohn et al, 1960), consequently, these emulsions are not recommended for administration to man in doses exceeding 75 g fat/ day for 14 consecutive days.…”

“…The anaemia is regarded as haemolytic (Loewy et al, 1943;Levenson, Upjohn & Sheehy, 1957;Artz, 1959;Alexander & Zieve, 1961). Liver damage and spontaneous bleeding may also occur (Artz, 1959;Cohn et al, 1960), consequently, these emulsions are not recommended for administration to man in doses exceeding 75 g fat/ day for 14 consecutive days. Such effects, called 'long-term reactions' or 'overloading syndrome', have not been described in connection with the soybean oil emulsion.…”

“…After long-term infusions of cottonseed oil emulsions in man and in the dog, ulcers in the stomach and duodenum have been observed (Jordan, 1957;Levenson et al, 1957;Artz, 1959;Werr & Preston, 1959;Cohn et al, 1960;Hartwig et al, 1961). Liver disturbances with jaundice and abnormal bromsulphthalein-retention, as well as increased thymol turbidity and cephalin flocculation, D. Hallberg et al…”

Lipids

“…The most common side effect was fever 11 . It was also noted to have a significant impact on the blood coagulation mechanisms and liver function 12 , 13 . Also described was an “overloading syndrome” after 10–20 days of cottonseed oil infusion at a dose of 1–1.5 g/kg/d.…”