Document Detail


New parenteral lipid emulsions for clinical use.
MedLine Citation:
PMID:  16804134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Routine use of parenteral lipid emulsions (LE) in clinical practice began in 1961, with the development of soybean oil (SO) - based LE. Although clinically safe, experimental reports indicated that SO-based LE could exert a negative influence on immunological functions. Those findings were related to its absolute and relative excess of omega-6 polyunsaturated fatty acids (PUFA) and the low amount of omega-3 PUFA and also to its high PUFA content with an increased peroxidation risk. This motivated the development of new LE basically designed along the reduction of omega-6 PUFA and the omega-3 PUFA addition in order to obtain balanced levels of the omega-6/omega-3 ratio. The new LE for clinical use (available in Europe and South America) are differentiated by their content in polyunsaturated (omega-6 and omega-3), monounsaturated, and saturated fatty acids (FA), as well as FA source of their origin, including soy, coconut, olive, and fish oil. This article presents the new LE nutrition and energy functions but also its biochemical, metabolic, and immunomodulating aspects, according to their FA content. LE at 20% when infused from 1.0 to 2.0 g/kg body weight/day rates, either alone or in association with amino acids and glucose, are safe and well tolerated in routine clinical practice. LE combining SO with medium-chain triglycerides and/or olive oil have less omega-6 PUFA and are better metabolized, with less inflammatory and immunosuppressive effects than in relation to pure SO-based LE. The omega-3 PUFA used alone or as component of a new and complex LE (soy, MCT, olive and fish oil) has demonstrated anti-inflammatory and immunomodulatory effects.
Authors:
Dan L Waitzberg; Raquel Susana Torrinhas; Thiago Manzoni Jacintho
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  JPEN. Journal of parenteral and enteral nutrition     Volume:  30     ISSN:  0148-6071     ISO Abbreviation:  JPEN J Parenter Enteral Nutr     Publication Date:    2006 Jul-Aug
Date Detail:
Created Date:  2006-06-28     Completed Date:  2006-11-27     Revised Date:  2007-02-21    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  351-67     Citation Subset:  IM    
Affiliation:
Laboratório de Fisiologia e Distúrbios Esfincterianos of University of São Paulo, School of Medicine, Department of Gastroenterology, Surgical Division, São Paulo, Brazil. dan@ganep.com.br
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MeSH Terms
Descriptor/Qualifier:
Fat Emulsions, Intravenous / adverse effects,  standards*,  therapeutic use
Fatty Acids, Omega-3 / metabolism*
Fatty Acids, Omega-6 / metabolism
Humans
Lipid Peroxidation / drug effects*
Oils
Parenteral Nutrition* / adverse effects,  methods,  standards
Soybean Oil
Chemical
Reg. No./Substance:
0/Fat Emulsions, Intravenous; 0/Fatty Acids, Omega-3; 0/Fatty Acids, Omega-6; 0/Oils; 8001-22-7/Soybean Oil

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