Fat Emulsions, Intravenous ; administration & dosage ; chemistry ; metabolism ; Humans ; Lipid Peroxidation ; Nutritional Support ; methods

Injectable lipid emulsions have been routinely used in patients since 1960s as a nutritional supplement for patients requiring parenteral nutrition. In recent years, lipid injectable emulsions have been extensively studied as a kind of novel drug carrier, also the quality problems of the lipid emulsion attract more and more attentions gradually. Large diameter tail of injectable lipid emulsions as a significant quality control indicator should pay more attention. Regarding to the defect of detecting large diameter tail of lipid injectable emulsions in our country, the purpose of this article is to summarize the techniques of detecting large diameter tail, illustrate the impacts of large lipid droplet on the quality of lipid injectable emulsions, emphasize the importance of detecting large diameter tail in lipid emulsions and provide guidance for researching and developing lipid emulsions in domestic market.
Drug Stability ; Fat Emulsions, Intravenous ; chemistry ; Lipids ; chemistry ; Parenteral Nutrition Solutions ; chemistry ; Particle Size ; Quality Control

Unexpected occurrence of local anesthetic toxicity is not rare and can cause fatal complications that do not respond to any known drug of intervention. Recently, the successful use of lipid emulsion for local anesthetic toxicity has been reported and recommended as a rescue method for cardiac or neurologic complications. We report a case of seizure attack and respiratory arrest successfully recovered with the use of intravenous lipid emulsion. Clinicians must be aware of the beneficial role of lipid emulsion in cases of local anesthetic toxicity.
Anesthetics, Local ; Ankle* ; Antidotes ; Fat Emulsions, Intravenous ; Neurotoxicity Syndromes ; Resuscitation* ; Seizures

At an intensive care unit, four neonates died consecutively within 80 minutes. Citrobacter freundii was isolated from blood samples of the 4 patients. It was also cultured from the leftover SMOFlipid that had been infused intravenously into the patients. In this in vitro study, we evaluated the bacterial growth kinetics and change in size of fat globules in SMOFlipid contaminated with C. freundii. Following the growth of bacteria, pH of SMOFlipid decreased to < 6, and the number of fat globules larger than 5 µm increased. Pulmonary fat embolism is proposed as a possible cause of the sudden deaths as well as fulminant sepsis.
Bacteria ; Citrobacter freundii* ; Citrobacter* ; Death, Sudden* ; Embolism, Fat ; Fat Emulsions, Intravenous ; Humans ; Hydrogen-Ion Concentration ; In Vitro Techniques ; Infant, Newborn* ; Infusions, Intravenous* ; Intensive Care Units ; Kinetics ; Sepsis

OBJECTIVE: To study the clinical effect of multi-oil fat emulsion for parenteral nutrition support in extremely low birth weight (ELBW) infants. METHODS: A retrospective analysis was performed for 49 ELBW infants who were admitted from January 1, 2018 to July 30, 2020, with an age of ≤14 days on admission and a duration of parenteral nutrition of > 14 days. According to the type of lipid emulsion received, the ELBW infants were divided into two groups: soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOF) ( RESULTS: The 49 ELBW infants had a mean birth weight of (892±83) g and a mean gestational age of (28.2±2.3) weeks. There was no significant difference between the two groups in the incidence rates of hemodynamically significant patent ductus arteriosus, intraventricular hemorrhage, neonatal necrotizing enterocolitis, retinopathy of prematurity, bronchopulmonary dysplasia (BPD), grade Ⅲ BPD, sepsis, and pneumonia ( CONCLUSIONS The application of multi-oil fat emulsion in ELBW infants does not reduce the incidence rate of complications, but compared with MCT/LCT emulsion, SMOF can reduce the severity of PNAC in ELBW infants.
Birth Weight ; Emulsions ; Fat Emulsions, Intravenous ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Parenteral Nutrition ; Retrospective Studies ; Soybean Oil

BACKGROUNDThe nutritional support is one of the important therapeutic strategies for the elderly patients with severe sepsis, but there is controversial in choosing a parenteral nutrition formulation. This study was designed to compare the therapeutic effects of structured lipid emulsion, physically mixed medium, and long-chain fat emulsion in the treatment of severe sepsis in elderly patients.

METHODSA total number of 64 elder patients with severe sepsis were enrolled in the study. After a week of enteral nutritional support, the patients were randomly divided into research (structured lipid emulsion as parenteral alimentation) and control groups (physically mixed medium and long-chain fat emulsion as parenteral alimentation). The alterations of plasma albumin, lipid metabolism, and blood glucose level were recorded after parenteral alimentation and were compared between the two groups.

RESULTSThe plasma levels of albumin, prealbumin, cholesterol, and triglyceride were decreased in all the patients after one week of enteral nutritional support treatment (t = 7.78, P = 0.000; t = 10.21, P = 0.000; t = 7.99, P = 0.000; and t = 10.99, P = 0.000). Further parenteral alimentation with different lipid emulsions had significant effects on the serum prealbumin and albumin (t = 3.316, P = 0.002; t = 3.200, P = 0.002), whilst had no effects on the blood glucose and triglyceride level (t = 7.78, P = 0.000; t = 4.228, P = 0.000). In addition, the two groups had a significantly different Apache II score, ventilator time, and hospital stay time (t = -2.213, P = 0.031; t = 2.317, P = 0.024; t = 2.514, P = 0.015).

CONCLUSIONSThe structured lipid emulsion was safe as parenteral nutrition for elderly patients with severe sepsis. It was demonstrated to be superior to the physically mixed medium and long-chain fat emulsion with respect to the protein synthesis and prognosis.

Aged ; Emulsions ; Fat Emulsions, Intravenous ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Parenteral Nutrition ; methods ; Sepsis ; blood ; drug therapy ; Serum Albumin ; analysis ; Triglycerides ; blood

Aconitum is a genus of various species of flowering plants that belongs to the Family Ranunculaceae. Most Aconitum sp. have extremely toxic alkaloid substances such as aconitine, mesaconitine and hypaconitine. Among these substances, aconitine can cause fatal cardiotoxicity by activating sodium channels followed by calcium channels in myocardial cells. Even though there have been various therapeutic plans suggested comprising antidotes based on diverse case reports and studies, there is no confirmatory treatment protocol for aconite poisoning. Here, we report an aconite poisoning patient who had refractory ventricular tachyarrhythmia that did not respond to intravenous amiodarone therapies even though they were sustained for over 2 hours, but showed successful recovery following intravenous fat emulsions (IFE) therapy.
Aconitine ; Aconitum* ; Amiodarone ; Antidotes ; Calcium Channels ; Cardiotoxicity ; Clinical Protocols ; Fat Emulsions, Intravenous ; Flowers ; Humans ; Poisoning* ; Ranunculaceae ; Sodium Channels ; Tachycardia

Aconitum is a genus of various species of flowering plants that belongs to the Family Ranunculaceae. Most Aconitum sp. have extremely toxic alkaloid substances such as aconitine, mesaconitine and hypaconitine. Among these substances, aconitine can cause fatal cardiotoxicity by activating sodium channels followed by calcium channels in myocardial cells. Even though there have been various therapeutic plans suggested comprising antidotes based on diverse case reports and studies, there is no confirmatory treatment protocol for aconite poisoning. Here, we report an aconite poisoning patient who had refractory ventricular tachyarrhythmia that did not respond to intravenous amiodarone therapies even though they were sustained for over 2 hours, but showed successful recovery following intravenous fat emulsions (IFE) therapy.
Aconitine ; Aconitum* ; Amiodarone ; Antidotes ; Calcium Channels ; Cardiotoxicity ; Clinical Protocols ; Fat Emulsions, Intravenous ; Flowers ; Humans ; Poisoning* ; Ranunculaceae ; Sodium Channels ; Tachycardia

Herbal products have been used for therapeutic purposes for a long time. However, many herbs can be toxic and even life-threatening. If refractory ventricular tachycardia (VT) is caused by herbal products and shows no response to conventional therapy, intravenous lipid emulsion (ILE) therapy can be considered. We report a case of herbal intoxication leading to refractory VT, which was successfully treated with ILE therapy. A 36-year-old woman with aplastic anemia presented with mental changes. She had taken an unknown herbal decoction three days before visiting the hospital. Soon after coming to the hospital, she went into cardiac arrest. Cardiopulmonary resuscitation was performed, and return of spontaneous circulation with VT was achieved. Synchronized cardioversion was then performed and amiodarone was administered. However, VT with pulse continued, so ILE therapy was attempted, which led to the resolution of VT.
Adult ; Amiodarone ; Anemia, Aplastic ; Cardiopulmonary Resuscitation ; Electric Countershock ; Fat Emulsions, Intravenous ; Female ; Heart Arrest ; Herb-Drug Interactions ; Humans ; Tachycardia, Ventricular

OBJECTIVETo investigate the effect of intralipid on protein consumption in severe burned patients. METHODS; Sixty-seven nonoperative patients with severe burns were divided into Intralipid treatment group and non-intralipid treatment group (control group), and the former was treated with 20% intralipid (500 ml once a day) from postburn day 4 for 10 consecutive days. Venous blood samples were collected from these patients for testing total protein, albumin, total cholesterol and triglyceride on postburn days 1, 7 and 14, respectively.

RESULTSThe levels of total protein, albumin, total cholesterol and triglyceride were within normal range on postburn day 1 in both groups, and only the albumin level was lowered in the groups on day 7 but at comparable magnitudes (32+/-4.83 vs 31+/-5.04 g/L, P<0.05). In contrast, the levels of total protein, albumin, total cholesterol and triglyceride were below the normal range on postburn day 14 in both groups, but intralipid treatment group showed more albumin loss than the control group (28+/-6.46 vs 23+/-7.03 g/L, P<0.01).

CONCLUSIONIntralipid (20%) provides good energy source to ameliorate albumin loss in severe burned patients.

Adolescent ; Adult ; Burns ; metabolism ; therapy ; Fat Emulsions, Intravenous ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Serum Albumin ; metabolism