Postmortem Findings in Three Patients Treated With Intravenous Fat Emulsions

Hessov, I; Melsen, F.; Haug, Agner

doi:10.1001/archsurg.1979.01370250068014

Cited by 52 publications

(12 citation statements)

References 9 publications

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“…High-fat diets administered enterally or parenterally result in decreased cell-mediated immunity. 25,196 High-fat reg-imens have also been shown to inhibit immunoglobulin synthesis33 and complement (C2) production,' negatively affect neutrophiI27, 32,197 and reticuloendothelial cell function, 28,29,41,95,103,104,198 and are associated with an increased incidence of infection. 27,40,46,199 The immunosuppression caused by excessive fat in the diet may reflect membrane-related functions, or it may involve alterations in eicosanoid production.…”

Section: Fish Oilmentioning

confidence: 99%

Invited Review: Selection of Optimal Lipid Sources in Enteral and Parenteral Nutrition

Gottschlich¹

1992

Nut in Clin Prac

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The manipulation of dietary fat intake can affect the response to disease, injury, and infection. These effects include enhancement or inhibition of immune function, altered susceptibility to cardiovascular disease, promotion or maintenance of gut integrity, and prevention of total parenteral nutrition-induced hepatic dysfunction. These effects may occur as a result of changes in the fatty acid composition of biomembranes or changes in concentrations of lipid moieties such as prostaglandins or leukotrienes. Those fats that have been shown to affect physiologic function include long-chain, medium-chain, and short-chain fatty acids and omega-3 and omega-6 fatty acids. Currently available enteral and parenteral products used for nutrition support contain widely varied amounts of these different fatty acids. Therefore, the selection of the most appropriate product or nutrition support regimen for an individual patient requires an understanding of the metabolism of these different fat substrates, their therapeutic indications, and the contraindications and controversies that surround their use. This article reviews these issues and also focuses on several alternate lipid sources such as short-chain fatty acids, medium-chain fatty acids, omega-3 fatty acids, and blended and structured lipids.

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Section: Fish Oilmentioning

confidence: 99%

Invited Review: Selection of Optimal Lipid Sources in Enteral and Parenteral Nutrition

Gottschlich¹

1992

Nut in Clin Prac

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“…Autopsy examinations from critically ill patients who have received soybean oil emulsions show considerable deposition of milky white clotted clumps of lipid in the heart, kidney, and lungs (13). Recent studies by Goodenough and Wolfelo reveal that approximately 8% of administered LCT emulsions are immediately oxidized and the remainder are retained in the body as neutral fats.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Lipid Emulsions on Reticuloendothelial System Function in the Injured Animal

Hamawy

Moldawer

Georgieff

et al. 1985

J Parenter Enteral Nutr

155

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Use of intravenous lipid emulsions in trauma and sepsis still remains controversial. In order to examine the impact lipid emulsions have on host defense against bacterial infection during total parenteral nutrition (TPN), 56 male Sprague-Dawley rats underwent jugular cannulation and were randomly divided into three groups, each receiving one of three TPN regimens. All regimens delivered approximately 250 kcal/kg X body weight/day, of which 12.5 g were as amino acids. Group 1 received 100% of the nonprotein calories as glucose (AA + G). Group 2 was given 50% of the nonprotein calories as a longchain triglyceride emulsion (100% LCT). Group 3 received 50% of nonprotein calories as a mixed lipid system, composed of medium- and long-chain triglycerides (75% MCT/25% LCT). After 24 hr on intravenous nutrition, all animals received bilateral septic femur fractures and were continued on TPN for 3 days. On the last day, the level of bacteremia and the in vivo response to an intravenous challenge of 59Fe-labeled Escherichia coli were examined. Three days following the septic injury, animals given MCT as part of their lipid calories were not bacteremic, whereas the other groups had greater than 10(2) cfu/ml of blood. Animals receiving TPN with MCT sequestered a greater percentage of exogenously administered bacteria in the liver and sequestered less in the lung compared to animals given 100% LCT (p less than 0.05). From these data, we conclude that parenteral nutrition formulas where LCT has been partially replaced with MCT may better support host bactericidal capacity than similar regimens comprised of LCT as the sole lipid source.

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“…Fat-overload syndrome can result from either overall total calorie overfeeding, overfeeding of lipids, or both [45]. The most commonly observed complications include respiratory distress, coagulopathy, abnormal liver function tests (LFTs), and hypertriglyceridemia [46,47]. Hepatic steatosis was commonly observed in the early days of hyperalimentation, when the practice of overfeeding was widespread.…”

Section: Under and Overfeedingmentioning

confidence: 99%

Systemic Approach to Parenteral Nutrition in the ICU

Peterson

Chen²

2010

CDS

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The nutrition support clinician must understand and evaluate all aspects of parenteral nutrition (PN) to maximize benefits while avoiding unfavorable consequences for the patients in the intensive care unit. The various aspects in caring for the PN patient include appropriate patient selection, intravenous access choice and maintenance, and individualized PN prescription to meet each patient's unique macronutrient and micronutrient requirements. Once the PN prescription has been determined, the clinician should also be familiar with the compounding process to ensure the final solution is safe for infusion. PN is one of the most complex solutions prepared in the pharmacy with numerous ingredients. Due to the number of components in the PN solution, physicochemical incompatibilities are a common and serious problem, thus specific compounding sequence and guidelines must be followed to avoid precipitation of mixed products. Once the PN solution is ready for infusion, protocols should be in place to assure safe administration. Close monitoring for tolerance of electrolytes and macronutrients, as well as glucose control is necessary initially; whereas monitoring of specific micronutrients is crucial in long-term PN usage. A standardized process for ordering, preparing, administering and monitoring PN is recommended to assure patient safety.

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Postmortem Findings in Three Patients Treated With Intravenous Fat Emulsions

Cited by 52 publications

References 9 publications

Invited Review: Selection of Optimal Lipid Sources in Enteral and Parenteral Nutrition

Invited Review: Selection of Optimal Lipid Sources in Enteral and Parenteral Nutrition

The Effect of Lipid Emulsions on Reticuloendothelial System Function in the Injured Animal

Systemic Approach to Parenteral Nutrition in the ICU

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