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Individualization of the infusion rate of a soybean oil–based intravenous lipid emulsion for inpatients, based on baseline triglyceride concentrations: A population pharmacokinetic approach
Author(s) -
Fukushima Keizo,
Omura Kenji,
Goshi Satoshi,
Okada Akira,
Tanaka Motomu,
Tsujimoto Takae,
Iriyama Keiji,
Sugioka Nobuyuki
Publication year - 2022
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1002/jpen.2111
Subject(s) - pharmacokinetics , triglyceride , medicine , population , adverse effect , soybean oil , emulsion , pharmacology , chemistry , cholesterol , biochemistry , environmental health , pathology
Background A rapid infusion rate for intravenous lipid emulsion (ILE) can cause adverse effects; therefore, safe and efficient infusion rates are desired. This study aimed to develop a triglyceride (TG) kinetic model after soybean oil–based ILE (SO‐ILE) administration and individualize the infusion rate via a population pharmacokinetic approach. Methods Eighty‐three inpatients were enrolled in this prospective observational study. A TG kinetic model was applied to the observations based on population pharmacokinetics using a nonlinear mixed‐effect model. The patients’ characteristics and laboratory parameters were evaluated to identify predictors of TG kinetics, and the maximum acceptable infusion rate was defined as that for which the maximum TG concentration did not exceed 400 mg/dl in 90% of patients. Results No adverse events associated with SO‐ILE administration were observed. The developed TG kinetic model explained the observed TG concentrations and identified the baseline TG concentration and body weight as predictors of TG kinetics. The estimated maximum acceptable infusion rates greatly varied among individuals, ranging from <0.01 to 0.3 g/kg/h. Conclusion The present study suggested the necessity and demonstrated the feasibility of individualizing the infusion rates of SO‐ILE, using a population pharmacokinetic approach.