Lipid infusion for parenteral nutrition

SMOFlipid 20% is an intravenous lipid emulsion, containing soybean oil 30%, medium-chain triglycerides 30%, olive oil 25 %, and fish oil 15 %, with specific ω-6/ω-3 FAs ratio (2.5:1). It was developed to provide energy, essential fatty acids (FAs), and long-chain ω-3 FAs as a mixed emulsion containing α-tocopherol (~0.2 mg/ml).

SMOFlipid as a mixture is eliminated faster than long chain triglycerides (LCT) with lower triglyceride levels during infusion. Olive oil has the slowest clearance rate of the components (somewhat slower than LCT) and medium chain triglycerides (MCT) the fastest. Fish oil in a mixture with LCT has the same clearance rate as LCT alone.

Hypersensitivity to fish, egg, soya or peanut protein; severe hyperlipidemia; severe liver insufficiency; severe blood coagulation disorders; severe renal insufficiency without access to hemofiltration or dialysis; acute shock; Acute pulmonary edema, hyperhydration, decompensated cardiac insufficiency. Unstable conditions (e.g. severe post-traumatic conditions, uncompensated DM, acute MI, stroke, embolism, metabolic acidosis & severe sepsis & hypotonic dehydration).

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Common: Slight increase in body temp; Uncommon (≧1/1000 to <1/100): Lack of appetite, nausea, vomiting, chills.

IV infusion, Adults: 1.0 - 2.0 g fat /kg/day, corresponding to 5 -10 ml/kg/day; infusion rate:＜0.75 ml/kg/hour Neonates and infants:The initial dose should be 0.5 - 1.0 g fat/kg /day;Children: It is recommended not to exceed a daily dose of 2 g fat/kg /day, corresponding to 10 ml /kg/day.