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The Role of Alternative Lipid Emulsions in Critically Ill Patients
Author(s) -
Manzanares William,
Langlois Pascal L.,
Heyland Daren K.
Publication year - 2014
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 - 10.1177/0148607114526452
Subject(s) - medicine , intensive care unit , intensive care , critically ill , family medicine , emergency medicine , intensive care medicine
Lipid emulsions (LEs) are a component of parenteral nutrition (PN) providing a dense source of energy and essential fatty acids. In critically ill patients, commonly used LEs have been rich in long-chain triglycerides (LCTs) providing a high percentage of linoleic acid (ω-6 polyunsaturated fatty acids [ω-6 PUFA] 18:2 ω-6). The current literature suggests that intravenous (IV) soybean-oil (SO) and safflower-based LEs are able to promote production of pro-inflammatory prostanoids and leukotrienes and therefore increase oxidative stress and systemic inflammation in the critically ill. In 2006, it was suggested that inclusion of ω-6-based LEs might be detrimental, which is more probable in the most seriously ill patients. Withholding lipid emulsion high in SO has been recommended in patients who tolerate some EN and who require short term PN (< 10 days).