A case of fat overload syndrome after rapid infusion of SMOFlipid emulsion in an adult

Moon, Hyung Jun; Hwang, In Chul; Lee, Jung Won; Hong, Sae‐Yong

doi:10.1016/j.ajem.2015.08.044

Cited by 7 publications

(15 citation statements)

References 5 publications

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“…One case report was of a 2‐year‐old girl who received a rapid infusion of Smoflipid, 100 mL of Smoflipid over 30 minutes (3.6 g/kg/h), which is significantly higher than the recommended rate . In another case, a 72‐year‐old man received 500 mL of Smoflipid over 4 hours and the patient experienced symptoms of fat overload syndrome 1 hour after infusion . The manufacturer dosage information states that the maximum infusion rate for Smoflipid is not to exceed 0.5 mL/kg/h .…”

Section: Dosage and Other Considerations Of Composite Mixed‐oil Ilementioning

confidence: 99%

“…The manufacturer dosage information states that the maximum infusion rate for Smoflipid is not to exceed 0.5 mL/kg/h . The adult patient's weight was not mentioned as part of the case study, so we are unable to determine whether the infusion exceeded this rate …”

Section: Dosage and Other Considerations Of Composite Mixed‐oil Ilementioning

confidence: 99%

“…[45][46][47] There have been case reports of fat overload syndrome with use of Smoflipid. 48,49 Although the most recent ASPEN/SCCM Adult Guidelines and ASPEN/SCCM Pediatric Guidelines do not suggest or recommend lipid emulsion rate limits, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the European Society for Clinical Nutrition and Metabolism guidelines suggest lipids should be infused at 0.13-0.17 g/kg/h for infants and 0.08-0.13 g/kg/h for older children. 5,50,51 One case report was of a 2-year-old girl who received a rapid infusion of Smoflipid, 100 mL of Smoflipid over 30 minutes (3.6 g/kg/h), which is significantly higher than the recommended rate.…”

Section: Dosage and Other Considerations Of Composite Mixed-oil Ilementioning

confidence: 99%

“…48 In another case, a 72-year-old man received 500 mL of Smoflipid over 4 hours and the patient experienced symptoms of fat overload syndrome 1 hour after infusion. 49 The manufacturer dosage information states that the maximum infusion rate for Smoflipid is not to exceed 0.5 mL/kg/h. 1 The adult patient's weight was not mentioned as part of the case study, so we are unable to determine whether the infusion exceeded this rate.…”

Section: Dosage and Other Considerations Of Composite Mixed-oil Ilementioning

confidence: 99%

“…1 The adult patient's weight was not mentioned as part of the case study, so we are unable to determine whether the infusion exceeded this rate. 49…”

Section: Dosage and Other Considerations Of Composite Mixed-oil Ilementioning

confidence: 99%

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Impact of Intravenous Lipid Emulsions Containing Fish Oil on Clinical Outcomes in Critically Ill Surgical Patients: A Literature Review

2018

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A fish oil (FO)–containing intravenous lipid emulsion (ILE; FO ILE) has been approved for use in the United States; however, similar formulations have been used throughout Europe and China in intensive care units since the 1990s. This literature review evaluates the evidence regarding the effectiveness of FO ILE on clinical outcomes in the critically ill surgical patient population. The review of available evidence demonstrates that ILEs containing FO lower triglyceride concentrations, inflammatory markers, and liver function enzymes, and improve morbidity and mortality outcomes in critically ill surgical patients.

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Section: Dosage and Other Considerations Of Composite Mixed‐oil Ilementioning

confidence: 99%

Section: Dosage and Other Considerations Of Composite Mixed‐oil Ilementioning

confidence: 99%

Section: Dosage and Other Considerations Of Composite Mixed-oil Ilementioning

confidence: 99%

Section: Dosage and Other Considerations Of Composite Mixed-oil Ilementioning

confidence: 99%

“…1 The adult patient's weight was not mentioned as part of the case study, so we are unable to determine whether the infusion exceeded this rate. 49…”

Section: Dosage and Other Considerations Of Composite Mixed-oil Ilementioning

confidence: 99%

See 3 more Smart Citations

Impact of Intravenous Lipid Emulsions Containing Fish Oil on Clinical Outcomes in Critically Ill Surgical Patients: A Literature Review

2018

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Investigation of parenteral nutrition-induced hepatotoxicity using human liver spheroid co-cultures

Mihajlovic,

De Boever,

Tabernilla

et al. 2024

Arch Toxicol

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Parenteral nutrition (PN) is typically administered to individuals with gastrointestinal dysfunction, a contraindication for enteral feeding, and a need for nutritional therapy. When PN is the only energy source in patients, it is defined as total parenteral nutrition (TPN). TPN is a life-saving approach for different patient populations, both in infants and adults. However, despite numerous benefits, TPN can cause adverse effects, including metabolic disorders and liver injury. TPN-associated liver injury, known as intestinal failure-associated liver disease (IFALD), represents a significant problem affecting up to 90% of individuals receiving TPN. IFALD pathogenesis is complex, depending on the TPN components as well as on the patient’s medical conditions. Despite numerous animal studies and clinical observations, the molecular mechanisms driving IFALD remain largely unknown. The present study was set up to elucidate the mechanisms underlying IFALD. For this purpose, human liver spheroid co-cultures were treated with a TPN mixture, followed by RNA sequencing analysis. Subsequently, following exposure to TPN and its single nutritional components, several key events of liver injury, including mitochondrial dysfunction, endoplasmic reticulum stress, oxidative stress, apoptosis, and lipid accumulation (steatosis), were studied using various techniques. It was found that prolonged exposure to TPN substantially changes the transcriptome profile of liver spheroids and affects multiple metabolic and signaling pathways contributing to liver injury. Moreover, TPN and its main components, especially lipid emulsion, induce changes in all key events measured and trigger steatosis.

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One‐year Experience With Composite Intravenous Lipid Emulsion in Children on Home Parenteral Nutrition

Raphael¹,

Mitchell²,

Carey³

et al. 2020

J. pediatr. gastroenterol. nutr.

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Background: Composite lipid emulsion (CLE) composed of soybean oil, medium-chain triglycerides, olive oil, and fish oil is approved in the US for parenterally fed adults. For stable children discharged on home parenteral nutrition (HPN) without cholestasis (direct bilirubin > 2.0 mg/dL), CLE has theoretical benefits over soybean-based intravenous lipid emulsion due to reduced phytosterol exposure with higher calorie support to permit reduced glucose infusion rates (GIRs), omega-3 supplementation, and supplemental α-tocopherol. Methods: In this prospective, single-center open-label research study, safety and efficacy outcomes were evaluated in patients on HPN younger than 18 years treated with CLE at 1 to 3 g · kg−1 · day−1 over 12 months. The primary outcome was change in anthropometrics and GIRs compared with baseline. Secondary outcomes were changes in fatty acid profiles and liver function and enzyme tests compared with baseline. Results: Fifty-seven subjects were treated with a median age of 7 years. The diagnosis was short bowel syndrome in 72%. Change in practice was associated with a decrease in mean GIRs from 17 to 14 mg · kg−1 · h−1 at 4 to 6 months postbaseline and beyond with a coincidental decline in mean arachidonic acid and stable growth parameters. No significant adverse events were noted. Conclusions: CLE was safe and well-tolerated in stable children on HPN at 1 year, but further studies are needed in this population to appreciate long-term outcomes.

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A case of fat overload syndrome after rapid infusion of SMOFlipid emulsion in an adult

Cited by 7 publications

References 5 publications

Impact of Intravenous Lipid Emulsions Containing Fish Oil on Clinical Outcomes in Critically Ill Surgical Patients: A Literature Review

Impact of Intravenous Lipid Emulsions Containing Fish Oil on Clinical Outcomes in Critically Ill Surgical Patients: A Literature Review

Investigation of parenteral nutrition-induced hepatotoxicity using human liver spheroid co-cultures

One‐year Experience With Composite Intravenous Lipid Emulsion in Children on Home Parenteral Nutrition

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