Biomaterial Database

Hepatic dysfunction in patients receiving intravenous lipid emulsions. 2023

John M Miles

Division of Endocrinology, Diabetes and Clinical Pharmacology, Department of Medicine, University of Kansas School of Medicine, Kansas City, Kansas, USA.

Until recently, intravenous lipid emulsions (ILEs) have consisted of soybean oil (SO) only. This review addresses recent developments in the field, including the problem of intestinal failure associated liver disease (IFALD) that can occur with the use of ILEs in children and adults, and newer ILEs that may minimize and reverse IFALD. Cholestasis is the primary manifestation of IFALD in premature infants receiving ILEs, whereas in older children and adults, steatosis is predominant. Two alternative ILEs have been extensively investigated for both safety and efficacy. SMOF, an ILE containing medium chain triglyceride, soybean oil, olive oil and fish oil (FO), is now widely used in both children and adults. A newer FO ILE is approved for use in children only. However, in case reports FO ILE has been shown to improve IFALD in adults. A number of new studies suggest that cholestasis from ILEs is dose-related. IFALD does not improve in many patients after transition from SO to SMOF, but partial or complete replacement with FO can halt and reverse IFALD. Adverse hepatic effects from ILEs are to some extent dose-related. Overfeeding with fat or with carbohydrate, or simply providing excessive calories in general, may be responsible. More research is needed investigating dose-related effects of macronutrients on liver injury.

UI	MeSH Term	Description	Entries
D007410	Intestinal Diseases	Pathological processes in any segment of the INTESTINE from DUODENUM to RECTUM.	Disease, Intestinal,Diseases, Intestinal,Intestinal Disease
D008107	Liver Diseases	Pathological processes of the LIVER.	Liver Dysfunction,Disease, Liver,Diseases, Liver,Dysfunction, Liver,Dysfunctions, Liver,Liver Disease,Liver Dysfunctions
D010288	Parenteral Nutrition	The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously).	Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D002779	Cholestasis	Impairment of bile flow due to obstruction in small bile ducts (INTRAHEPATIC CHOLESTASIS) or obstruction in large bile ducts (EXTRAHEPATIC CHOLESTASIS).	Bile Duct Obstruction,Biliary Stasis,Bile Duct Obstructions,Biliary Stases,Cholestases,Duct Obstruction, Bile,Duct Obstructions, Bile,Obstruction, Bile Duct,Obstructions, Bile Duct,Stases, Biliary,Stasis, Biliary
D004655	Emulsions	Colloids formed by the combination of two immiscible liquids such as oil and water. Lipid-in-water emulsions are usually liquid, like milk or lotion. Water-in-lipid emulsions tend to be creams. The formation of emulsions may be aided by amphiphatic molecules that surround one component of the system to form MICELLES.	Emulsion
D005217	Fat Emulsions, Intravenous	Emulsions of fats or lipids used primarily in parenteral feeding.	Intravenous Fat Emulsion,Intravenous Lipid Emulsion,Lipid Emulsions, Intravenous,Emulsion, Intravenous Fat,Emulsion, Intravenous Lipid,Emulsions, Intravenous Fat,Emulsions, Intravenous Lipid,Fat Emulsion, Intravenous,Intravenous Fat Emulsions,Intravenous Lipid Emulsions,Lipid Emulsion, Intravenous
D005395	Fish Oils	Oils high in unsaturated fats extracted from the bodies of fish or fish parts, especially the LIVER. Those from the liver are usually high in VITAMIN A. The oils are used as DIETARY SUPPLEMENTS. They are also used in soaps and detergents and as protective coatings.	Fish Liver Oils,Fish Oil,Liver Oils, Fish,Oil, Fish,Oils, Fish,Oils, Fish Liver
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069463	Olive Oil	Oil extracted from fruit of the OLIVE TREE (genus Olea).	Olive Oils,Oil, Olive,Oils, Olive
D013024	Soybean Oil	Oil from soybean or soybean plant.	Soya Oil,Soy Bean Oil,Oil, Soy Bean,Oil, Soya,Oil, Soybean,Oils, Soy Bean,Oils, Soya,Oils, Soybean,Soy Bean Oils,Soya Oils,Soybean Oils