title: A.S.P.E.N. position paper: Clinical role for alternative intravenous fat emulsions.
abstract: The currently available, standard soybean oil (SO)-based intravenous fat emulsions (IVFEs) meet the needs of most parenteral nutrition (PN) patients. There are alternative oil-based fat emulsions, such as medium-chain triglycerides (MCTs), olive oils (OOs), and fish oils (FOs), that, based on extensive usage in Europe, have an equivalent safety profile to SO. These alternative IVFEs are metabolized via different pathways, which may lead to less proinflammatory effects and less immune suppression. These alternative oil-based IVFEs are not currently available in the United States. Many patients who require IVFEs are already in a compromised state. Such patients could potentially have better clinical outcomes when receiving one of the alternative IVFEs to diminish the intake of the potentially proinflammatory ω-6 fatty acid-linoleic acid-which comprises more than 50% of the fatty acid profile in SO. Further research is needed on these alternative oil-based IVFEs to identify which IVFE oils or which combination of oils may be most clinically useful for specific patient populations.
authors.affiliation: St. Elizabeth Health Center, Youngstown, OH 44501-1790, USA. vince_vanek@hmis.org
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Vanek
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Seidner
authors.forename: Penny
authors.initials: P
authors.lastname: Allen
authors.forename: Bruce
authors.initials: B
authors.lastname: Bistrian
authors.forename: Sharon
authors.initials: S
authors.lastname: Collier
authors.forename: Kathleen
authors.initials: K
authors.lastname: Gura
authors.forename: John M
authors.initials: JM
authors.lastname: Miles
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Valentine
authors.forename: Marty
authors.initials: M
authors.lastname: Kochevar
mesh_terms: D005060:Europe; D005217:Fat Emulsions, Intravenous / Q000737:chemistry / Q000627:therapeutic use*; D005395:Fish Oils / Q000627:therapeutic use; D006801:Humans; D007109:Immunity / Q000187:drug effects*; D007249:Inflammation / Q000139:chemically induced* / Q000517:prevention & control; D019787:Linoleic Acid / Q000009:adverse effects*; D008055:Lipids / Q000009:adverse effects / Q000627:therapeutic use*; D000069463:Olive Oil; D010288:Parenteral Nutrition / Q000009:adverse effects; D010938:Plant Oils / Q000627:therapeutic use; D012955:Societies, Medical; D013024:Soybean Oil / Q000009:adverse effects / Q000737:chemistry* / Q000627:therapeutic use; D014280:Triglycerides / Q000627:therapeutic use; D014481:United States
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D008055:Lipids; D000069463:Olive Oil; D010938:Plant Oils; D014280:Triglycerides; D013024:Soybean Oil; D019787:Linoleic Acid