Abstract
Background: Despite providing significant benefits, home parenteral nutrition (HPN) can be associated with complications such as infections, intestinal failure–associated liver disease, and metabolic abnormalities. Soybean oil (SO)–based intravenous lipid emulsion (ILE) has been noted to contribute to some of these complications, leading to the development of alternative sources of ILE. Mixed-oil (MO) ILE has recently been approved for use in adults with short-term studies revealing a benefit over SO ILE. Currently there is a paucity of data regarding long-term use in the HPN population. Methods: The current study reports our experience with MO ILE in 9 HPN patients. Results: A total of 9 patients (3 women and 6 men) with average age of 48.1 ± 15.1 years and a median HPN use of 9.9 years (9.0 months–30.7 years) were transitioned from SO ILE to MO ILE as a result of intolerance. The 9 patients tolerated MO ILE well for 140.7 ± 29.7 days. The percentage of calories provided through ILE increased from 7.6 ± 6.5% to 18.4 ± 8.2% (P =.003), whereas the dextrose decreased from 66.9 ± 8.4% to 56.9 ± 5.5% (P =.0007). Although statistical significance was not reached, there was a trend toward improvement in alkaline phosphatase from 138.0 (52–884) to 106 (47–512; P =.09). Conclusion: MO ILE was well tolerated in this small cohort and led to improvement in the macronutrient composition of HPN while providing a trend toward improvement in liver studies. These results are promising; however, additional randomized control trials are needed to delineate the true benefit.
Original language | English (US) |
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Pages (from-to) | 851-857 |
Number of pages | 7 |
Journal | Nutrition in Clinical Practice |
Volume | 33 |
Issue number | 6 |
DOIs | |
State | Published - Dec 2018 |
Keywords
- fatty acids
- home parenteral nutrition
- intravenous fat emulsions
- intravenous lipid emulsions
- parenteral nutrition
- parenteral nutrition solutions
ASJC Scopus subject areas
- Medicine (miscellaneous)
- Nutrition and Dietetics