Parenteral Nutrition and Lipids.
Parenteral Nutrition and Lipids.
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DOI：
10.3390/nu9040388
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发表时间：
2017-04-14
期刊：
影响因子：
5.9
通讯作者：
Gramlich L
中科院分区：
文献类型：
--
作者：
Raman M;Almutairdi A;Mulesa L;Alberda C;Beattie C;Gramlich L
脂质具有多种生理作用，在生物学上至关重要。数十年来，大豆油脂肪乳剂一直是北美肠外营养脂质制剂的支柱。在肠外营养中使用静脉注射脂肪乳剂可最大限度地减少对葡萄糖（非蛋白质热量的主要来源）的依赖，并预防必需脂肪酸缺乏症的临床后果。新兴文献表明，与大豆脂质相比，使用替代脂质（如橄榄/大豆制剂）和组合脂质（如大豆/MCT/橄榄/鱼油）具有获益，因为它们具有较低的炎症特性，具有免疫调节作用，具有较高的抗氧化剂含量，降低胆汁淤积风险，并改善某些患者亚组的临床结局。本文的目的是回顾IVLE的历史，其组成，广泛使用的IVLE的不同代，选择脂质时要考虑的变量，以及IVLE的并发症以及如何最大限度地减少它们。
Lipids have multiple physiological roles that are biologically vital. Soybean oil lipid emulsions have been the mainstay of parenteral nutrition lipid formulations for decades in North America. Utilizing intravenous lipid emulsions in parenteral nutrition has minimized the dependence on dextrose as a major source of nonprotein calories and prevents the clinical consequences of essential fatty acid deficiency. Emerging literature has indicated that there are benefits to utilizing alternative lipids such as olive/soy-based formulations, and combination lipids such as soy/MCT/olive/fish oil, compared with soybean based lipids, as they have less inflammatory properties, are immune modulating, have higher antioxidant content, decrease risk of cholestasis, and improve clinical outcomes in certain subgroups of patients. The objective of this article is to review the history of IVLE, their composition, the different generations of widely available IVLE, the variables to consider when selecting lipids, and the complications of IVLE and how to minimize them.