• Provision of nonprotein calories to patients whose total caloric needs cannot be met by carbohydrates (glucose) alone, usually as part of parenteral nutrition.
• Treatment and prevention of essential fatty acid deficiency in patients receiving long-term parenteral nutrition (provides linoleic acid).

Contraindicated in:

• Hyperlipidemias
• Lipoid nephrosis
• Pancreatitis accompanied by lipemia
• Hypersensitivity to egg products (emulsifier is egg yolk phospholipid), legumes, soybeans, or fat emulsions.

Use Cautiously in:

• Thromboembolic disorders
• Severe liver or pulmonary disease
• Anemia or bleeding disorders
• Patients who are at risk for fat embolism.

Exercise Extreme Caution in:

• Preterm infants (↓ ability to clear fat emulsion).

Seen only with long-term use.†

CV: chest pain.

Endo: hypertriglyceridemia.

GI: hepatomegaly†, jaundice†, nausea, pancreatitis, vomiting.

Local: phlebitis at IV site.

Resp: INTRAVASCULAR FAT ACCUMULATION(PRETERM INFANTS ONLY).
Misc: fever, infection, chills, hypersensitivity reactions.

Drug-Drug:

• Concurrent use withpropofol may ↑ risk of hypertriglyceridemia.

• Emulsion for IV Use: 10%; 20%; 30%;

Total Parenteral Nutrition

• IV (Adults): Initial dose: 1 g/kg/day, increase by 0.5–1 g/kg/day to a maximum of 2.5 g/kg/day.
• IV (Children 1 mo): Initial dose: 0.5–1 g/kg/day, increase by 0.5 g/kg/day to amaximum of 3 g /kg/day.
• IV (Neonates premature): Initial dose: 0.25–0.5 g/kg/day, increase by 0.25–0.5 g/kg/day to a maximum of 3 g/kg/day.

Essential Fatty Acid Deficiency

• IV (Adults and Children): Provide 8–10% of caloric intake as fat, infuse once or twice weekly.

Intralipid, Liposyn III

• Acts as a nonprotein calorie source.

• Provision of essential fatty acids and nonprotein calories.

Therapeutic Classification: caloric sources

Absorption: IV administration results in complete bioavailability.

Distribution: Distributes into intravascular space.

Metabolism/Excretion: Cleared by conversion to triglycerides, then to free fatty acids and glycerol by lipoprotein lipase. Free fatty acids are transported to tissues, where they may be oxidized as an energy source or re-stored as triglycerides.

Half-life: 30–60 min.

• Explain the purpose of fat emulsion to the patient prior to administration.

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