[Administration of a new fat emulsion in intensive care].

Abstract

A new lipid emulsion for parenteral nutrition, Elolipid, was evaluated for in vitro stability as a component of an all-in-one nutrition solution and, in an open prospective investigation, for clinical tolerance and utilisation in intensive care patients with a broad spectrum of underlying diseases and organ dysfunctions. In vitro stability was determined by photon correlation spectroscopy (mean particle diameter) and Coulter Counter cell sizing (particle size distribution) after 0, 24, 48, 96 h of storage at temperatures of 4 degrees C and 25 degrees C. Mean particle diameter of 330 nm was not altered at any storage time or temperature. The portion of particles with an diameter of greater than 1,000 nm increased mildly during storage of 96 h at room temperature. 31 critically ill patients (mean age 55 +/- 3 years) entered the clinical study: 23 subjects were on artificial ventilation, 15 acquired septicemia, 9 renal insufficiency, and 7 acute or chronic hepatic failure. Fat was given as a component of an all-in-one solution at a rate of 1 g/kg b.w./day for a mean duration of 10 +/- 2 days. Plasma triglycerice concentrations rose mildly between days 3 and 5 only, but in none of the patients the infusion had to be stopped. Lipid-related disturbances of glucose or electrolyte metabolism, hepatic function, cholestasis, induction of disseminated coagulation, impairment of pulmonary gas exchange or renal function were not seen. 7 of 31 patients (22%) died. Side effects of complications attributable to the fat infusion could not be identified. It is concluded that the new lipid emulsion Elolipid is stable as a component of an all-in-one parenteral nutrition solution, is free of side effects and is well-tolerated and utilized even in critically ill patients with multiple organ dysfunctions.