Use of Lipids in Adult Patients Requiring Parenteral Nutrition in the Home Setting.
fatty acid
fish oil
home parenteral nutrition
intestinal failure
intestinal failure associated liver disease
intravenous lipid emulsion
omega-3
phytosterol
soybean oil
Journal
JPEN. Journal of parenteral and enteral nutrition
ISSN: 1941-2444
Titre abrégé: JPEN J Parenter Enteral Nutr
Pays: United States
ID NLM: 7804134
Informations de publication
Date de publication:
02 2020
02 2020
Historique:
received:
15
07
2019
revised:
24
09
2019
accepted:
11
11
2019
entrez:
13
2
2020
pubmed:
13
2
2020
medline:
4
3
2021
Statut:
ppublish
Résumé
It is estimated that over 25,000 Americans receive home parenteral nutrition (HPN), mostly because of intestinal failure (IF). Although there is significant variability in the fluid and energy needs of patients receiving HPN, intravenous lipid emulsions (ILEs) are an essential part of the macronutrient composition, serving as an excellent source of non-protein energy, as well as supplying essential fatty acids. However, the long-term use of ILEs in particular may be associated with some detrimental health effects, such as intestinal failure associated liver disease (IFALD). Although there is lack of unifying diagnosis, IFALD can present as cholestasis, steatosis, or fibrosis, with a prevalence that ranges between 5% and 43%. The development of IFALD tends to be multifactorial. Risk factors of IFALD can include those related to IF, inflammation/infection, and long-term parenteral nutrition. Some studies have shown a link between development of IFALD and ILE dose, especially if the dose is >1 g/kg/d, with high ω-6:ω-3 polyunsaturated fatty acid (PUFA) ratio and phytosterol content being theorized as some contributing factors. Thus, efforts have been made to use alternative oils (olive oil, medium-chain triglycerides, and fish oil) to reduce the soybean-oil content of ILE, which tends to be high in ω-6 PUFA and phytosterols. Although additional long-term clinical data are emerging, this strategy, as reviewed in the current manuscript, has shown to provide some benefit in both prevention and treatment of IFALD and other sequelae of HPN.
Substances chimiques
Fat Emulsions, Intravenous
0
Fatty Acids, Omega-6
0
Fish Oils
0
Olive Oil
0
Soybean Oil
8001-22-7
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
S39-S44Informations de copyright
© 2019 American Society for Parenteral and Enteral Nutrition.
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