Document Detail


The role of an intravenous fat emulsion composed of fish oil in a parenteral nutrition-dependent patient with hypertriglyceridemia.
MedLine Citation:
PMID:  18042955     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypertriglyceridemia is a common complication in patients receiving parenteral nutrition (PN). Management typically involves withholding the IV fat emulsion (IVFE) until serum triglyceride levels normalize. In some instances, this practice may predispose patients to the development of essential fatty acid deficiency (EFAD) unless alternative therapies such as oral or topical oils are used. This is especially true in patients unable to tolerate enteral intake. We describe the management of hypertriglyceridemia in a 12-year-old boy dependent on PN who developed EFAD due to prolonged use of fat-free PN. His course was further complicated by PN-associated liver disease. Treatment involved the use of an IVFE derived from fish oils. Within 3 weeks, there was clinical improvement in EFAD and hypertriglyceridemia. The patient's triene:tetraene ratio decreased from 0.207 to 0.044 (normal: 0.013-0.05). Similarly, his serum triglyceride levels decreased from 628 mg/dL to 183 mg/dL (normal: <200 mg/dL). After 2 months of treatment, he was successfully transitioned to enteral feedings; hepatic function normalized, as did the essential fatty acid profile and serum triglycerides levels. This suggests that using fish-oil-based IVFE may be an effective alternative to conventional IVFE in PN-dependent patients whose clinical course is complicated by hypertriglyceridemia.
Authors:
Kathleen Gura; Robbert Strijbosch; Sarah Arnold; Christopher McPherson; Mark Puder
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition     Volume:  22     ISSN:  0884-5336     ISO Abbreviation:  Nutr Clin Pract     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-11-28     Completed Date:  2008-03-04     Revised Date:  2010-04-29    
Medline Journal Info:
Nlm Unique ID:  8606733     Medline TA:  Nutr Clin Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  664-72     Citation Subset:  IM; N    
Affiliation:
Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. kathleen.gura@childrens.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Child
Fat Emulsions, Intravenous / chemistry*
Fatty Acids, Essential / deficiency*
Fish Oils / chemistry,  therapeutic use*
Humans
Hypertriglyceridemia / etiology,  prevention & control*
Liver Diseases / etiology
Male
Parenteral Nutrition / adverse effects*
Treatment Outcome
Triglycerides / blood
Chemical
Reg. No./Substance:
0/Fat Emulsions, Intravenous; 0/Fatty Acids, Essential; 0/Fish Oils; 0/Triglycerides
Comments/Corrections
Comment In:
Nutr Clin Pract. 2008 Jun-Jul;23(3):349   [PMID:  18595869 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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