Evaluation of an Intravenous Lipid Emulsion for Critically Ill Adult UF / Health ICU Patients Requiring Parenteral Nutrition
Project Description: Lipid Emulsions are widely accepted as an integral component of Parenteral Nutrition (PN) formularies. Until recently, Intralipid, a Soybean based product with a high concentration of a pro-inflammatory mixture, (7:1 omega-6 to omega-3 Polyunsaturated Fatty Acids (PUFA), was the supplemental lipid emulsion prescribed at University of Florida. With increasing evidence suggesting that omega-6 PUFAs are harmful (pro-inflammatory and immunosuppressive), a race to develop a more complex lipid emulsion began. Hence, the emergence of SMOF-Lipid, containing a more favorable balance of lipids: (S)oybean, (M)edium Chain Fatty Acids, (O)live Oil, and (F)ish Oil producing a ratio of 2.5:1 omega-6 to omega-3 PUFAs. Even more intriguing is the fish oil is rich with the omega-3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). These two PUFAs are the precursor for Specialized Pro-Resolving Mediators (SPMs) that provide an endogenous inflammatory break through expeditious inflammation resolution without untoward immunosuppression. Furthermore, SMOFLipid has a far superior hepatotoxicity profile than Intralipid, producing significantly less cholestasis. It is postulated, therefore, that this may improve clinical outcomes for adult patients already prone to oxidative insult. There remains a gap of knowledge, however, regarding the clinical efficacy of such formulary specifically for adult ICU patients.
QPI: Goeto, Dantes, (firstname.lastname@example.org)
Collaborators: Martin, Rosenthal, (email@example.com)
UF Health Big Aims: Enhance the Patient Experience None
MeSH Keywords: Abdomen, Acute, TPN, ICU, SMOF Lipid, hepatotoxicity