title: Practicalities of lipids: ICU patient, autoimmune disease, and vascular disease.
abstract: Although the use of lipids should be individualized, certain generalizations are appropriate. 1. Lipid infusion should be limited in the fulminately septic patient to 10% of total calories in an effort to reduce immunosuppression. 2. The stressed, nonseptic patient with difficulties in ventilator weaning or TPN-induced hepatic dysfunction may reap benefit from a reduction in dextrose calories and the provision of daily lipids. 3. Patients with severe autoimmune disease have had mild amelioration of symptoms with PUFA supplementation. The relative benefits of omega-6 vs omega-3 continue to be examined. 4. Dietary immunomodulation in transplant and burns remains an area of active investigation. 5. Patients with fat-free TPN show transient declines in serum lipids. The development of a "fat-solubilizer" remains in the experimental realm. 6. The provision of fish oil, high in W-3 EPA, has shown promise in atherosclerosis and immunomodulation. The changes in the relative amounts of each prostaglandin class depend on precursor prevalence.
authors.affiliation: Department of Surgery, University of Rochester School of Medicine and Dentistry, New York 14642.
authors.forename: H C
authors.initials: HC
authors.lastname: Sax
mesh_terms: D001327:Autoimmune Diseases / Q000188:drug therapy*; D003422:Critical Care / Q000379:methods*; D005217:Fat Emulsions, Intravenous / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007109:Immunity / Q000187:drug effects; D014652:Vascular Diseases / Q000188:drug therapy*
chemical_list: D005217:Fat Emulsions, Intravenous