Biomaterial Database

Failure of topical vegetable oils to prevent essential fatty acid deficiency in a critically ill patient receiving long-term parenteral nutrition. 1994

G S Sacks, and R O Brown, and P Collier, and K A Kudsk

Department of Clinical Pharmacy, University of Tennessee, Memphis.

This case report describes the failure of topical vegetable oils containing esters of linoleic acid to prevent essential fatty acid deficiency in a critically ill patient with trauma. A 40-year-old black man injured in a motor vehicle accident developed essential fatty acid deficiency after being maintained on long-term, fat-free parenteral nutrition plus topical vegetable oil application because of the presence of severe hypertriglyceridemia. Biochemical evidence of this deficiency included a decrease in serum linoleic, a-linolenic, and arachidonic acid levels with a corresponding increase in oleic and palmitoleic acid levels. Cutaneous manifestations consistent with this syndrome were also present. After 3 weeks of daily topical treatments with vegetable oils rich in linoleic acid, biochemical abnormalities of deficiency were still evident. Over the following 2 1/2 months, 4% to 22% of the total caloric intake was delivered as intravenous fat in addition to continued topical administration of vegetable oil. Only after supplementation with intravenous fat did the patient demonstrate clinical and biochemical signs of improvement. The results show that cutaneous administration of vegetable oils as the sole source of linoleic acid may be unable to prevent or treat essential fatty acid deficiency in a critically ill surgical patient.

UI	MeSH Term	Description	Entries
D008041	Linoleic Acids	Eighteen-carbon essential fatty acids that contain two double bonds.	Acids, Linoleic
D008297	Male		Males
D009104	Multiple Trauma	Multiple physical insults or injuries occurring simultaneously.	Injuries, Multiple,Trauma, Multiple,Wounds, Multiple,Multiple Injuries,Polytrauma,Injury, Multiple,Multiple Injury,Multiple Traumas,Multiple Wound,Multiple Wounds,Polytraumas,Traumas, Multiple,Wound, Multiple
D009829	Oleic Acids	A group of fatty acids that contain 18 carbon atoms and a double bond at the omega 9 carbon.	Octadecenoic Acids,Acids, Octadecenoic,Acids, Oleic
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
D010938	Plant Oils	Oils derived from plants or plant products.	Oils, Plant,Oils, Vegetable,Plant Oil,Vegetable Oil,Vegetable Oils,Oil, Plant,Oil, Vegetable
D003422	Critical Care	Health care provided to a critically ill patient during a medical emergency or crisis.	Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D005223	Fats	The glyceryl esters of a fatty acid, or of a mixture of fatty acids. They are generally odorless, colorless, and tasteless if pure, but they may be flavored according to origin. Fats are insoluble in water, soluble in most organic solvents. They occur in animal and vegetable tissue and are generally obtained by boiling or by extraction under pressure. They are important in the diet (DIETARY FATS) as a source of energy. (Grant & Hackh's Chemical Dictionary, 5th ed)
D005228	Fatty Acids, Essential	Long chain organic acid molecules that must be obtained from the diet. Examples are LINOLEIC ACIDS and LINOLENIC ACIDS.	Acids, Essential Fatty,Essential Fatty Acids
D005229	Fatty Acids, Monounsaturated	Fatty acids which are unsaturated in only one position.	Monounsaturated Fatty Acid,Acid, Monounsaturated Fatty,Acids, Monounsaturated Fatty,Fatty Acid, Monounsaturated,Monounsaturated Fatty Acids