The Effect of Hypertriglyceridemia on Extracorporeal Membrane Oxygenation

Medical nutrition therapy in patients receiving ECMO: Evidence‐based guidance for clinical practice

“…The propofol rate could be modified throughout the day, which may allow for a small volume of mixed oil or ω‐3–enriched lipid emulsion to avoid excess intakes of proinflammatory ω‐6 fatty acids 59 . Case reports have shown severe hypertriglyceridemia (>1000 mg/dl or 11.4 mmol/l) may be associated with sequestration of triglycerides in the circuit oxygenator leading to suboptimal oxygenation on ECMO 62–64 . To avoid complications related to hypertriglyceridemia, omitting or decreasing PN lipids and/or considering alternative sedation modalities should be considered in the setting of elevated serum triglyceride concentrations >400 mg/dl 65 …”

“…59 Case reports have shown severe hypertriglyceridemia (>1000 mg/dl or 11.4 mmol/l) may be associated with sequestration of triglycerides in the circuit oxygenator leading to suboptimal oxygenation on ECMO. [62][63][64] To avoid complications related to hypertriglyceridemia, omitting or decreasing PN lipids and/or considering alternative sedation modalities should be considered in the setting of elevated serum triglyceride concentrations >400 mg/dl. 65 In general, PN or SPN are less susceptible to interruptions compared with EN and may improve delivery of macronutrients and micronutrients in patients who are critically ill. 52 Thereby, PN or SPN may contribute to the avoidance of large cumulative energy-protein debts, which may be especially important for patients receiving ECMO who frequently experience prolonged and complicated ICU stays.…”