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Review
. 2025 Mar 1;28(2):104-113.
doi: 10.1097/MCO.0000000000001092. Epub 2024 Dec 2.

Parenteral lipid emulsions: the state of the art

Valentina Da Prat  1 , Riccardo Caccialanza  1 , Paolo Cotogni  2
Affiliations
Review

Parenteral lipid emulsions: the state of the art

Valentina Da Prat et al. Curr Opin Clin Nutr Metab Care. .

Abstract

Purpose of review: Several types of injectable lipid emulsions (ILEs) have become available for parenteral nutrition. The purpose of this review is to highlight the most recent and interesting articles in the field of ILEs.

Recent findings: Recent literature has compared ILEs in various clinical scenarios (e.g. abdominal surgery, chronic intestinal failure, critical illness, and preterm birth). Favorable clinical effects of ILEs containing fish oil have been observed in studies on surgical patients with Crohn's disease, critically ill patients, and patients with intestinal failure-associated liver dysfunction, whereas other trials have shown no clear benefit. Ongoing research is focused on finding novel strategies to reduce liver toxicity of ILEs, including the use of 'artificial intelligence' tools and liver organoids. Promising new applications for ILEs are emerging, including the prevention of neonatal hypoxic brain injury.

Summary: Although ILEs with the goal of reducing the levels of pro-inflammatory omega-6 fatty acids appear to confer some advantage in some settings (e.g. surgery), conclusive data on the superiority of one ILE over another are lacking. In particular, research is needed to compare different types of mixed-oil ILEs with each other and with pure fish oil ILEs.

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References

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    1. Miles JM. Hepatic dysfunction in patients receiving intravenous lipid emulsions. Curr Opin Clin Nutr Metab Care 2023; 26:278–283.
    1. Driscoll DF. Proinflammatory mediators in lipid emulsions and parenteral nutrition–associated liver disease: review of leading factors. J Parenter Enteral Nutr 2023; 47:710–717.
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    1. Weylandt KH, Karber M, Xiao Y, et al. Impact of intravenous fish oil on omega-3 fatty acids and their derived lipid metabolites in patients with parenteral nutrition. J Parenter Enteral Nutr 2023; 47:287–300.

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