title: The effects of different IV fat emulsions on clinical outcomes in critically ill patients.
abstract: OBJECTIVE
  To examine the effects of different IV fat emulsions on clinical outcomes in critically ill patients.
  
  
  METHODS
  Secondary analysis of data from a prospective multicenter study.
  
  
  METHODS
  An international sample of ICUs.
  
  
  METHODS
  Adult patients who were admitted to the ICU for more than 72 hours, were mechanically ventilated within 48 hours, received exclusive parenteral nutrition for more than or equal to 5 days, and did not change IV fat emulsion type during the data collection period.
  
  
  METHODS
  Demographic and clinical data were collected for up to 12 days, until death, or discharge from the ICU, whichever came first. Clinical outcomes were recorded at 60 days following ICU admission.
  
  
  METHODS
  Lipid-free, soybean, medium-chain triglyceride, olive, and fish oils in parenteral nutrition were compared using an adjusted Cox proportional hazard model to examine time to termination of mechanical ventilation alive, time to ICU discharge alive, and time to hospital discharge alive.
  
  
  RESULTS
  A total of 451 patients were included in this study: 70 (15.5%) in the lipid-free group, 223 (49.5%) in the soybean oil group, 65 (14.4%) in the medium-chain triglyceride group, 74 (16.4%) in the olive oil group, and 19 (4.9%) in the fish oil group. When compared with lipid-free parenteral nutrition, patients who received fish oil had a faster time to ICU discharge alive (hazard ratio, 1.84; 95% CI, 1.01-3.34; p = 0.05). When compared with soybean oil, patients who received olive oil or fish oil had a shorter time to termination of mechanical ventilation alive (hazard ratio, 1.43; 95% CI, 1.06-1.93; p = 0.02 and hazard ratio, 1.67; 95% CI, 1.00-2.81; p = 0.05, respectively) and a shorter time to ICU discharge alive (hazard ratio, 1.76; 95% CI, 1.30-2.39; p < 0.001 and hazard ratio, 2.40; 95% CI, 1.43-4.03; p = 0.001, respectively).
  
  
  CONCLUSIONS
  Use of alternative IV fat emulsions in parenteral nutrition, particularly olive and fish oil, was associated with improved clinical outcomes.
authors.affiliation: 1Food and Nutrition Services Department, Fraser Health Authority, Burnaby, BC, Canada. 2Department of Nutritional Sciences, School of Health Related Professions, Rutgers, The State University of New Jersey, Newark, NJ. 3Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada. 4Department of Medicine, Queen's University, Kingston, ON, Canada.
authors.forename: Christina E
authors.initials: CE
authors.lastname: Edmunds
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Brody
authors.forename: J Scott
authors.initials: JS
authors.lastname: Parrott
authors.forename: Susan M
authors.initials: SM
authors.lastname: Stankorb
authors.forename: Daren K
authors.initials: DK
authors.lastname: Heyland
mesh_terms: D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015992:Body Mass Index; D016638:Critical Illness / Q000628:therapy*; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000379:methods*; D010351:Patient Discharge; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: D005217:Fat Emulsions, Intravenous