Emergence of Mixed-Oil Fat Emulsions for Use in Parenteral Nutrition

Manpreet S. Mundi, Robert Martindale, Ryan T. Hurt

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

Since early work by Wretlind and Schuberth led to the development of a stable and safe intravenous fat emulsion (IFE) using soybean oil (SO) and egg phospholipid emulsifier, IFEs have become a crucial source of essential fatty acids and nonprotein energy in parenteral nutrition. However, largely due to their high ω-6 polyunsaturated fatty acid (PUFA) and phytosterol content, SO IFEs have been associated with complications, including a proinflammatory profile and hypertriglyceridemia, as well as intestinal failure–associated liver disease. Subsequent generations of IFEs have used other sources of triglycerides, including medium-chain triglycerides (MCTs), olive oil (OO), and fish oil (FO), to reduce the SO component. Although these IFEs showed some improvement in complications compared with SO IFE, the quest to develop an IFE with a better side effect profile and beneficial physiologic effects led to the development of a mixed-oil (MO) IFE (Smoflipid; 30% SO, 30% MCTs, 25% OO, and 15% FO) that was recently approved by the Food and Drug Administration. The use of a MO approach is theoretically and intuitively more physiologically similar to normal dietary human consumption. Although the data are from small, short-term trials, MO IFE results thus far have been promising, with some studies showing improved liver function tests, improvement in triglycerides, higher ω-3/ω-6 PUFA ratio, and higher α-tocopherol. Larger long-term studies are needed to ensure these theoretical benefits lead to significant improvement in clinical outcomes.

Original languageEnglish (US)
Pages (from-to)3S-13S
JournalJournal of Parenteral and Enteral Nutrition
Volume41
Issue number1_Suppl
DOIs
StatePublished - Nov 1 2017

Fingerprint

Intravenous Fat Emulsions
Soybean Oil
Parenteral Nutrition
Emulsions
Oils
Fats
Triglycerides
Fish Oils
Unsaturated Fatty Acids
Phytosterols
Essential Fatty Acids
Tocopherols
Hypertriglyceridemia
Liver Function Tests
United States Food and Drug Administration
Ovum
Liver Diseases
Phospholipids

Keywords

  • home nutrition support
  • lipids
  • nutrition
  • parenteral nutrition

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Emergence of Mixed-Oil Fat Emulsions for Use in Parenteral Nutrition. / Mundi, Manpreet S.; Martindale, Robert; Hurt, Ryan T.

In: Journal of Parenteral and Enteral Nutrition, Vol. 41, No. 1_Suppl, 01.11.2017, p. 3S-13S.

Research output: Contribution to journalReview article

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