Fat Emulsion

Synonym :

Lipid emulsion

Mechanism :

Fat emulsions are used as dietary supplements for patients who are unable to get enough fat in their diet, usually because of certain illnesses or recent surgery. Fats are used by the body for energy and to form substances needed for normal body functions.

Indication :

Source of calories and essential fatty acids for patients requiring parenteral nutrition of extended duration.

Contraindications :

The administration of 20% i.v. Fat emulsion is contraindicated in patients with disturbances of normal fat metabolism such as pathologic hyperlipemia, lipoid nephrosis or acute pancreatitis if accompanied by hyperlipidemia.

Dosing :

Start with 0.5 g fat/kg body weight/24 hours of 20% IV fat emulsion and may be increased in relation to the infant’s ability to eliminate fat (Max: 3 g fat/kg/24 hours).

Infusion rate: Not more than 0.05 ml/minute for the first 10 to 15 minutes. if no untoward reactions occur, the rate can be changed to permit infusion of 0.5 ml of 20% IV fat emulsion/kg/hour. Should make up no more than 60% of the total caloric input to the patient.

Adverse Effect :

Early adverse reactions: Cyanosis, allergic reactions, dyspnea, hyperlipidemia, hypercoagulability, vomiting, nausea, flushing, headache, increase in temperature, sweating, sleepiness, pain in the chest and back, dizziness, slight pressure over the eyes, and irritation at the site of infusion, and, rarely, thrombocytopenia in neonates.

Delayed adverse reactions: Hepatomegaly, jaundice due to central lobular cholestasis, leukopenia, thrombocytopenia, splenomegaly, transient increases in liver function tests, and overloading syndrome (fever, leucocytosis, focal seizures, hepatomegaly, splenomegaly and shock).

Hepatic Dose :

Use with caution in patients with severe hepatic impairment.