Annals of Nutrition and Metabolism

Review

Lipid Emulsions in Parenteral Nutrition

Adolph M.

Author affiliations

Klinik für Anästhesie, Operative Intensivmedizin und Rettungsmedizin, Stadtkrankenhaus Wolfsburg, Akademisches Lehrkrankenhaus der Universität Göttingen, Wolfsburg, Deutschland

Keywords: Total parenteral nutritionLipid emulsionMedium chain triglycerides/long chain triglyceridesFish oilOlive oilStructured triglyceridesα-Tocopherol

Related Articles for ""
Ann Nutr Metab 1999;43:1–13
https://doi.org/10.1159/000012761

Log in to MyKarger to check if you already have access to this content.




Forgot your password
Sign up to MyKarger

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more
CHF 38.00 *
EUR 35.00 *
USD 39.00 *

Select

KAB

Buy a Karger Article Bundle (KAB) and profit from a discount!


If you would like to redeem your KAB credit, please log in.

Save over 20% compared to the individual article price.

Learn more

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Access to all articles of the subscribed year(s) guaranteed for 5 years
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates

Select
* The final prices may differ from the prices shown due to specifics of VAT rules.

Article / Publication Details

First-Page Preview
Abstract of Review

Published online: June 04, 1999
Issue release date: June 1999

Number of Print Pages: 13
Number of Figures: 0
Number of Tables: 2

ISSN: 0250-6807 (Print)
eISSN: 1421-9697 (Online)

For additional information: https://www.karger.com/ANM

Abstract

Lipid emulsions containing a physical mixture of medium and long chain triglycerides (MCT/LCT) are a well-proven concept in parenteral nutrition of critically ill patients. Having a demonstrably higher utilization rate, MCT/LCT emulsions do not impair liver function, produce less immune and no reticuloendothelial system function compromise, and do not interfere with pulmonary hemodynamics or gas exchange. A reduced content of n–6 polyunsaturated fatty acids can also be obtained by using newer preparations based on structured triglycerides or olive oil. Further studies are necessary in order to investigate these new lipid emulsions versus the physical mixture of MCT/LCT. A promising substrate in the development of lipid emulsions can be seen in fish oils. With regard to current literature, fish oils have a beneficial influence on the pathophysiological response to endotoxins and exert important modulations on eicosanoid and cytokine biology. Furthermore their intravenous use may improve organ perfusion in different critical situations.



Related Articles:

References

  1. Spielmann D, Bracco U, Traitler H, Crozier G, Holman R, Ward M, Cotter R: Alternative lipids to ususal ω6 PUFAS: γ-Linolenic acid, α-linolenic acid, stearidonic acid, EPA, etc. J Parenter Enter Nutr 1988;12(suppl):111–123.
  2. Jarstrand C, Berghem L, Lahnborg G: Human granulocyte and reticuloendothelial system function during Intralipid infusion. J Parenter Enter Nutr 1978;2:663–670.
    External Resources
  3. Nordenström J, Jarstrand C, Wiernick A: Decreased chemotaxis and random migration of leukocytes during Intralipid infusion. Am J Clin Nutr 1979;32:2416–2422.
    External Resources
  4. Fisher GW, Hunter KW, Wilson SR, Mease D: Diminished bacterial defenses with Intralipid. Lancet 1980;ii:819–820.
  5. Sedman PC, Somers SS, Ramsden CW, Brennan TG, Guillou PJ: Effects of different lipid emulsions on lymphocyte function during total parenteral nutrition. Br J Surg 1991;78:1396–1399.
    External Resources
  6. Wan MF, Teo TC, Babayan VK, Blackburn GL: Lipids and the development of immune dysfunction and infection. J Parenter Enter Nutr 1983;12(suppl):43–48.
  7. Wolfram G: The use of lipid infusions in postoperative nutrition. Chir Gastroenterol 1994;10:173–176.
  8. Adolph M: Fett als Energieträger in der parenteralen Ernährung; in: Fett in der parenteralen Ernährung. Munich, Zuckschwerdt, 1998, vol 5, pp 43–45.
  9. Adolph M, Eckart J, Metges C, Neeser G, Wolfram G: Oxidation of long and medium chain triglycerides during total parenteral nutrition of severely injured patients (abstract). Clin Nutr 1988;7(suppl):78.
  10. Adolph M, Eckart J, Metges C, Neeser G, Wolfram G: Is there an influence of MCT on the LCT oxidation rate during total parenteral nutrition of trauma patients? (abstract). J Parenter Enter Nutr 1989;14(suppl):21.
  11. Adolph M, Hailer S, Eckart J: Serum phospholipid fatty acids in severely injured patients on total parenteral nutrition with medium chain/long chain triglyceride emulsions. Ann Nutr Metab 1995;39:251–260.
    External Resources
  12. Ball MJ: Parenteral nutrition in the critically ill: Use of a medium chain triglyceride emulsion. Intensive Care Med 1993;19:89–95.
    External Resources
  13. Dennison A, Ball M, Crowe P, Hands L, Kettlewell M: Total parenteral nutrition using conventional and medium chain triglycerides. J Parenter Enter Nutr 1988;4:360–366.
  14. Calon B, Poltecher T, Frey A, Ravenello J, Otteni J, Bach A: Long chain versus medium and long chain triglyceride based fat emulsion in parenteral nutrition of severe head trauma patients. Infusionstherapie 1990;17:246–248.
    External Resources
  15. Carpentier YA, Richelle M, Haumont D, Deckelbaum RJ: New developments in fat emulsion. Proc Nutr Soc 1990;49:375–380.
    External Resources
  16. Carpentier YA, Dubois DY, Siderova VS, Richelle M: Exogenous lipids and hepatic function; in Kinney JM, Tucker HN (eds): Organ Metabolism and Nutrition. New York, Raven Press, 1994, pp 349–367.
  17. Kuse ER, Kemnitz J, Kotzerke J, Wassmann R, Gubernatis G, Ringe B, Pichlmayr I: Fat emulsions in parenteral nutrition after liver transplantation: The recovery of the allografts RES function and histological observations. Clin Nutr 1990;9:331–336.
  18. Baldermann H, Wicklmayr M, Rett K, Banholzer P, Dietze G, Mehnert H: Changes of hepatic morphology during parenteral nutrition with lipid emulsion containing LCT or MCT/LCT quantified by ultrasound. J Parenter Enter Nutr 1991;15:601–603.
    External Resources
  19. Stein TP, Yoshida S, Schluter MD, Drews D, Assimon SA, Leskiw MJ: Comparison of intravenous nutrients on gut mucosal protein synthesis. J Parenter Enter Nutr 1994;18:447–452.
    External Resources
  20. Ota DM, Copeland EM, Corriere JM: The effects of 10% soybean emulsion on lymphocyte transformation. J Parenter Enter Nutr 1978;2:112–115.
    External Resources
  21. Monson JRT, Ramsden CW, MacFie J, Brennan TG, Gouillou PJ: Immunorestorative effect of lipid emulsions during total parenteral nutrition. Br J Surg 1986;73:843–846.
    External Resources
  22. Ota DM, Jessup MM, Babcock GF, Kirschbaum L, Mountain CF, McMurtray MJ, Copeland MJ: Immune function during intravenous administration of a soybean oil emulsion. J Parenter Enter Nutr 1985;9:23–27.
    External Resources
  23. Kinsella JE, Lokesh B, Broughton S, Whelan J: Dietary polyunsaturated fatty acids and eicosanoids: Potential effects on the modulation of inflammatory and immune cells: An overview. Nutrition 1990;6:24–44.
    External Resources
  24. Gogos CA, Zoumbos NC, Makri M, Kalfarentzos FE: Medium- and long-chain triglycerides have different effects on the synthesis of tumor necrosis factor by human mononuclear cells in patients under total parenteral nutrition. J Am Coll Nutr 1994;13:40–44.
    External Resources
  25. Gelas P, Cotte L, Poitevin-Later F, Pichard C, Leverve X, Barnoud D, Leclercq P, Touraine-Moulin F, Trepo C, Boulétreau P: Effect of parenteral medium- and long-chain triglycerides on lymphocyte subpopulations and functions in patients with acquired immunodeficiency syndrome: a prospective study. J Parenter Enter Nutr 1998;22:67–71.
    External Resources
  26. Waitzberg DL, Bellinati-Pires R, Salgado MM, Hypolito IP, Colleto GMDD, Yagi O, Yamamuro EM, Gama-Rodrigues J, Pinotti HW: Effect of total parenteral nutrition with different lipid emulsions on human monocyte and neutrophil functions. Nutrition 1997;13:128–132.
    External Resources
  27. Dutoid DF, Villet WT, Heydenrych J: Fat emulsion deposition in mononuclear phagocyte system. Lancet 1978;ii:898–902.
  28. Meurling S, Roos KA: Liver changes in rats on continuous and intermittent parenteral nutrition with and without fat. Acta Chir Scand 1981;147:475–480.
    External Resources
  29. Hamawy KJ, Moldawer LL, Georgieff M, Valicenti AJ, Babayan VK, Bistrian BR: Effect of lipid emulsions on the reticuloendothelial system function in the injured animal. J Parenter Enter Nutr 1985;9:559–565.
    External Resources
  30. Sobrado J, Moldawer LL, Pomposelli JJ, Mascioli EA: Lipid emulsions and reticuloendothelial system function in healthy and burned guinea pigs. Am J Clin Nutr 1985;42:85–863.
  31. Seidner DL, Mascioli EA, Istfan NW, Porter KA, Selleck K, Blackburn GL, Bistrian BR: Effects of long-chain triglyceride emulsions on reticuloendothelial system function in humans. J Parenter Enter Nutr 1989;13:614–619.
    External Resources
  32. Hageman JR, McCulloch KE, Gora P, Olsen E, Pachman L, Hunt CE: Intralipid alterations in pulmonary prostaglandin metabolism and gas exchange. Crit Care Med 1983;11:794–798.
    External Resources
  33. Hageman JR, Hunt CE: Fat emulsions and lung function. Clin Chest Med 1986;7:69–77.
    External Resources
  34. Hammermann C, Aramburo MJ: Intravenous lipids in newborn lungs. Thromboxane-mediated effects. Crit Care Med 1989;17:430–436.
    External Resources
  35. Hunt CE, Cora P, Inwood RJ: Pulmonary effects of intralipid: The role of intralipid as a prostaglandin precursor. Prog Lipid Res 1981;20:199–204.
    External Resources
  36. Radermacher P, Santak B, Strobach H, Schrör K, Tarnow J: Fat emulsions containing medium chain triglycerides in patients with sepsis syndrome: Effects on pulmonary hemodynamics and gas exchange. Intesive Care Med 1992;18:231–234.
  37. Venus B, Prager R, Patel CB, Sandoval E, Sloan P, Smith RA: Cardiopulmonary effects of intralipid infusion in critically ill patients. Crit Care Med 1988;16:587–590.
    External Resources
  38. Venus B, Prager R, Patel CB, Sandoval E: Hemodynamic and gas exchange alterations during intralipid infusion in patients with adult respiratory distress syndrome. Chest 1989;95:1278–1281.
    External Resources
  39. Branemark PI, Lindstrom J: Microcirculatory effect of emulsified fat in infusions. Circ Res 1964;15:124–130.
  40. Greene HL, Hazlett D, Demaree R: Relationship between Intralipid-induced hyperlipemia and pulmonary function. Am J Clin Nutr 1976;29:127–135.
    External Resources
  41. Fiaccadori E, Tortorella G, Gonzi GL, Beghi C, Albertini D, Pincolini S, Belli L, Avogaro A: Hemodynamic and respiratory effects of medium-chain and long-chain triglyceride fat emulsions: A prospective, randomized study. Riv Ital Nutr Parenter Enter 1997;15:6–14.
  42. Lemoyne M, Van Gossum A, Kurian R, Jeejeebhoy KN: Plasma vitamin E and selenium and breath pentane in home parenteral nutrition patients. Am J Clin Nutr 1988;48:1310–1315.
    External Resources
  43. Wispe JR, Bell EF, Roberts RJ: Lipid peroxidation in newborn rabbits: Effects of oxygen, lipid emulsions, and vitamin E. Pediatr Res 1986;20:505–507.
    External Resources
  44. Traber MG, Carpentier YA, Kayden HJ, Richelle M, Galeano NF, Deckelbaum RJ: Alterations in plasma α- and γ-tocopherol concentrations in response to intravenous infusion of lipid emulsions in humans. Metabolism 1993;42:701–709.
    External Resources
  45. Siderova AC, Richelle M, Dubois D, Van Gossum A, Sultan F, Carpentier YA: Intravenous α-tocopherol supplementation in patients receiving long-term home parenteral nutrition. Clin Nutr 1995;14:47–48.
  46. Nordenström J, Thörne A, Olivecrona A: Metabolic effects of infusion of a structured-triglyceride emulsion in healthy subjects. Nutrition 1995;11:269–274.
    External Resources
  47. Hultin M, Müllertz A, Zundel MA, Olivecrona G, Hansen TT, Deckelbaum RJ, Carpentier YA, Olivecrona T: Metabolism of emulsions containing medium- and long-chain triglycerides or interesterified triglycerides. J Lipid Res 1994;35:1850–1860.
    External Resources
  48. Lutz O, Lave T, Frey A, Meraihi Z, Bach AC: Activities of lipoprotein lipase and hepatic lipase on long- and medium chain triglyceride emulsions used in parenteral nutrition. Metabolism 1989;38:507–513.
    External Resources
  49. Magnusson Borg IK, Göran Sandberg L, Wennberg AK, Lindmark L, Ekman LG: Effects of a fat emulsion containing medium chain fatty acids and long chain fatty acids on protein and energy metabolism in partially hepatectomized rats. Clin Nutr 1995;14:23–28.
  50. Sandström R, Hyltander A, Körner U, Lundholm K: Structured triglycerides to postoperative patients: A safety and tolerance study. J Parenter Enter Nutr 1993;17:153–157.
    External Resources
  51. Sandström R, Hyltander A, Körner U, Lundholm K: Structured triglycerides were well tolerated and induced increased whole body fat oxidation compared with long-chain triglycerides in postoperative patients. J Parenter Enter Nutr 1995;19:381–386.
    External Resources
  52. Kruimel JW, Naber AHJ: Structured triglycerides. Educational Program, 19th ESPEN Congr, Amsterdam, 1997, pp 102–104.
  53. Granato D, Blum S, Zbinden I, Malnoe A, Rössle C, Forget D, Dutot G: Effect of ClinOleic®, an olive oil-based parenteral lipid emulsion, on lymphocyte function in vitro (abstract). Clin Nutr 1996;15(suppl 1):3.
  54. Dutot G, Melin C: Assessment of lipid peroxidation during lipid infusion: influence of fatty acid composition of fat emulsion (abstract). Clin Nutr 1991;10(suppl 2):50.
  55. Dutot G, Trimbo S, Melin C: Vitamin E intake can be optimized in parenteral nutrition by using a new olive oil based fat emulsion (abstract). 15th Int Congr Nutr, Adelaide, 1993.
  56. Arborati M, Ninio E, Chapman MJ, Sultan F: Comparison of lipoperoxide content and lipoperoxidability in parenteral fat emulsions with different triglyceride content (abstract). Clin Nutr 1997;16(suppl 2):O.18.
  57. Bang HO, Dyerberg J, Sinclair HM: The composition of the Eskimo food in northwestern Greenland. Am J Clin Nutr 1980:33:2657–2661.
  58. Dyerberg J, Bang HO, Hjorne N: Fatty acid composition of the plasma lipids in Greenland Eskimos. Am J Clin Nutr 1975;28:958–966.
    External Resources
  59. Fürst P: Old and new substrates in clinical nutrition. J Nutr 1998;128:789–796.
    External Resources
  60. Grimble RF: Dietary manipulation of the inflammatory response. Proc Nutr Soc 1994;51:285–294.
    External Resources
  61. Endres S, Ghorbani R, Kelley VE, Georgilis K, Lonnemann G, van der Meer JWM, Cannon JG, Rogers TS, Klempner MS, Weber PC, Schaefer EJ, Wolff SM, Dinarello CA: The effect of dietary supplementation with n–3 polyunsaturated fatty acids on the synthesis of interleukin-11 and tumor necrosis factor by mononuclear cells. N Engl J Med 1989;320:265–271.
    External Resources
  62. Lowry SF, Thompson WA: Nutrient modification of inflammatory mediator production. New Horiz 1994;2:164–174.
    External Resources
  63. Rola-Pleszczynski M: Differential effects of leukotriene B4 on T4+ and T8+ lymphocyte phenotype and immunoregulatory functions. J Immunol 1985;135:1357–1360.
    External Resources
  64. Morlion BJ, Torwesten E, Lessire H, Sturm G, Peskar BM, Fürst P, Puchstein C: The effect of parenteral fish oil on leucocyte membrane fatty acid composition and leukotriene-synthesizing capacity in patients with postoperative trauma. Metabolism 1996;45:1208–1213.
    External Resources
  65. Oliveira T, Carpentier YA, Hansen I, Deckelbaum RJ: Triglyceride hydrolysis of soy vs fish oil LCT emulsions. Clin Nutr 1992;11(suppl):44.
  66. Hamberger L, Carpentier YA, Hansen I, Deckelbaum RJ: In vitro lipolysis of MCT and fish oil containing emulsions: Evidence that longer chain fatty acids must be cleared as intact triglycerides in emulsion remnants. Clin Nutr 1996;15(suppl):23.
  67. Carpentier YA, Siderova VS, Richelle M, Deckelbaum RJ, Eggerickx D, Sultan F: Does the presence of fish oil in emulsion particles affect the elimination of MCT/LCT emulsion. Clin Nutr 1996;15(suppl):2.
  68. Cukier C, Waitzberg DL, Logullo AF, Bacchi CE, Soares SR, Travassos VH: Fish oil enriched TPN improves liver and lung phagocytosis in rats. Clin Nutr 1997;16(suppl 2):42.
  69. Wachtler P, König W, Senkal M, Kemen M, Köller M: Influence of a total parenteral nutrition enriched with ω–3 fatty acids on leukotriene synthesis of peripheral leukocytes and systemic cytokine levels in patients with major surgery. J Trauma 1997;42:191–198.
    External Resources
  70. Pscheidl E, Reisch S, Rügheimer E: Chemically defined structured lipids with omega–3 fatty acids maintain splanchnic blood flow in a low-dose continuous endotoxin model. Infusionsther Transfusionsmed 1994;21:380–387.
    External Resources
  71. Pscheidl E, Böke-Pröls Th: Omega–3 fatty acids enriched fat emulsions modulate splanchnic blood flow and microbial translocation in a low dose endotoxin rat model. Clin Nutr 1997;16(suppl 2):16.
  72. Schjøtt J, Brekke O-L, Jynge P, Bjerve KS, Hamazaki T: Infusion of EPA and DHA lipid emulsions: Effects on heart lipids and tolerance to ischaemia-reperfusion in the isolated rat heart. Scand J Clin Lab Invest 1993;53:873–877.
    External Resources
  73. Dupont I, Siderova VS, Vanweyenberg V, Eggerickx D, Lontie J-F, Deckelbaum RJ, Carpentier YA: Incorporation of alpha-tocopherol in plasma lipoproteins during and after infusion of fish oil containing emulsions. Clin Nutr 1997;16(suppl 2):2.

Article / Publication Details

First-Page Preview
Abstract of Review

Published online: June 04, 1999
Issue release date: June 1999

Number of Print Pages: 13
Number of Figures: 0
Number of Tables: 2

ISSN: 0250-6807 (Print)
eISSN: 1421-9697 (Online)

For additional information: https://www.karger.com/ANM

Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Article Tools
Article Details

1999, Vol.43, No. 1

June 1999

Article

Recommend This
TOP