title: Safety and efficacy of a new parenteral lipid emulsion (SMOF) for surgical patients: a systematic review and meta-analysis of randomized controlled trials.
abstract: To assess the comparative safety and efficacy of a new parenteral lipid emulsion containing soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOFlipid20%) for postoperative patients, a meta-analysis of randomized controlled trials (RCTs) was conducted. Six RCTs with a total of 306 patients were included in the analysis. The overall quality of evidence for each outcome was evaluated using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) software. Compared with a soybean-based (Lipoven20%) and a soybean- and olive oil-based (ClinOleic20%) lipid emulsion, SMOFlipid20% was associated with lower levels of hepatic enzymes, suggesting less toxicity. Changes in low-density lipoprotein triglyceride and C-reactive protein levels were also lower with SMOFlipid20% compared with Lipoven20%. Differences between SMOFlipid20% and a lipid emulsion containing medium- and long-chain triglycerides (MCT/LCT20%) were not statistically significant. For all trials, there were no significant differences in adverse events and length of hospital stay. The quality of evidence from the RCTs evaluating SMOF20% versus Lipoven20% was moderate, while most of the evidence from RCTs of SMOF20% versus ClinOleic20% and MCT/LCT20% lipid emulsions was low.
authors.affiliation: Evidence-Based Medicine Center of Lanzhou University, The First Clinical Medical School of Lanzhou University, Lanzhou, China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Tian
authors.forename: Xiangrong
authors.initials: X
authors.lastname: Yao
authors.forename: Rong
authors.initials: R
authors.lastname: Zeng
authors.forename: Rao
authors.initials: R
authors.lastname: Sun
authors.forename: Hongyan
authors.initials: H
authors.lastname: Tian
authors.forename: Chunhu
authors.initials: C
authors.lastname: Shi
authors.forename: Lun
authors.initials: L
authors.lastname: Li
authors.forename: Jinhui
authors.initials: J
authors.lastname: Tian
authors.forename: Kehu
authors.initials: K
authors.lastname: Yang
mesh_terms: D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D005395:Fish Oils / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008077:Lipoproteins, LDL / Q000008:administration & dosage / Q000009:adverse effects; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000379:methods*; D011182:Postoperative Care; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014280:Triglycerides / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D005217:Fat Emulsions, Intravenous; D005395:Fish Oils; D008077:Lipoproteins, LDL; D014280:Triglycerides; C032607:low density lipoprotein triglyceride
keywords: SMOFlipid20%; lipid emulsion; meta-analysis; surgery; total parenteral nutrition