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Practice Guideline
. 2020 Oct;35(5):769-782.
doi: 10.1002/ncp.10496. Epub 2020 May 27.

ASPEN Lipid Injectable Emulsion Safety Recommendations, Part 1: Background and Adult Considerations

Jay M Mirtallo  1   2 , Phil Ayers  3 , Joseph Boullata  4 , Kathleen M Gura  5   6 , Steven Plogsted  7 , Collin R Anderson  8 , Patricia Worthington  7 , David S Seres  9 , Emily Nicolai  10 , Mohammad Alsharhan  11 , Liliia Gutsul  12 , Angelina E Mason  13
Affiliations
Practice Guideline

ASPEN Lipid Injectable Emulsion Safety Recommendations, Part 1: Background and Adult Considerations

Jay M Mirtallo et al. Nutr Clin Pract. 2020 Oct.

Erratum in

  • Corrigendum.
    [No authors listed] [No authors listed] Nutr Clin Pract. 2022 Apr;37(2):482. doi: 10.1002/ncp.10843. Epub 2022 Jan 19. Nutr Clin Pract. 2022. PMID: 35043461 No abstract available.

Abstract

Lipid injectable emulsions (ILEs) are complex pharmaceutical formulations used as a source of energy and essential fatty acids in parenteral nutrition. Issues associated with ILE use are distinctly different from oral fat and arise from emulsion stability, dose, and infusion tolerance. Since 1975, soybean oil has been the consistent source oil used in ILE formulations in the US. Partly because of safety concerns with the soybean-based ILE and frequent and long-standing problems with product inventory shortages, new ILE products have become available. Gaps in ILE best practices create a risk for ILE safety errors in prescribing, compounding, and administration of these products. This paper provides information on appropriate indications, dosing, and methods to avoid potential errors with ILE products in the US. This paper (Part 1) will focus on ILE background, information, and recommendations for adult patients, whereas Part 2 of this series will focus on neonatal and pediatric patient-specific information.

Keywords: lipid injectable emulsion; parenteral nutrition process; recommendations; safety.

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References

    1. Mirtallo J, Canada T, Johnson D, et al, for the Task Force for the Revision of Safe Practices for Parenteral Nutrition. Safe practices for parenteral nutrition. JPEN J Parenter Enteral Nutr. 2004;28(6_suppl):S39-S70.
    1. Mirtallo JM, Dasta JF, Kleinschmidt KC, Varon J. State of the art review: intravenous fat emulsion: current applications, safety profile and clinical implications. Ann Pharmacother. 2010;44(4):688-700.
    1. Canadian Critical Care Nutrition. 2015. https://criticalcarenutrition.com/docs/CPGs%202015/9.2%202015.pdf. Accessed March 23, 2020.
    1. Singer P, Blaser AR, Berger MM, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38(1):48-79.
    1. Storey MA, Weber RJ, Besco K, Beatty S, Aizawa K, Mirtallo JM. Evaluation of parenteral nutrition errors in an era of drug shortages. Nutr Clin Pract. 2016;31(2):211-217.

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