Lipid emulsions in parenteral nutrition: does it matter?

Curr Opin Crit Care. 2023 Aug 1;29(4):293-299. doi: 10.1097/MCC.0000000000001058. Epub 2023 May 31.

Abstract

Purpose of review: Recently, clinicians have shown interest in switching patients to nonsoybean-based intravenous lipid emulsion (ILE) formulas for parental nutrition (PN) due to adverse outcomes related to high Omega-6 content in soybean oil (SO) ILE's. This review summarizes recent literature on improved clinical outcomes with new Omega-6 lipid-sparing ILE's in PN management.

Recent findings: Although there is a paucity of large-scale studies directly comparing Omega-6 lipid sparing ILE's with SO-based lipid emulsion use in PN in ICU patients, there is strong translational and meta-analysis evidence to suggest that lipid formulations containing fish oil (FO) and/or olive oil (OO) have favorable effects on immune function and improve clinical outcomes in ICU populations.

Summary: More research is needed to directly compare omega-6-sparing PN formulas with FO and/or OO versus traditional SO ILE's. However, current evidence is promising for improved outcomes using newer ILE's including reduced infections, shorter lengths of stay, and reduced costs.

Publication types

  • Review

MeSH terms

  • Fat Emulsions, Intravenous* / therapeutic use
  • Fish Oils / therapeutic use
  • Humans
  • Olive Oil
  • Parenteral Nutrition*
  • Soybean Oil / therapeutic use

Substances

  • Fat Emulsions, Intravenous
  • Fish Oils
  • Olive Oil
  • Soybean Oil