2024 Volume 58 Issue 1 Pages 41-49
Reluctance to administer lipid emulsion to patients undergoing treatment or as recommended by a nutritional support team may arise due to various restrictions or concerns regarding potential adverse effects. This paper aimed to discuss the appropriate use of lipid emulsion in clinical settings to enhance patient safety and convenience. We performed a literature review to assess the importance of nutritional therapy and nutritional intervention, the merits and demerits of lipid emulsion administration, the current situation in Japan, and differences in lipid formulations. Herein, we address issues regarding the usage of lipid emulsion including: 1. administration rate, 2. drug mixing, 3. administration to critically ill patients, and 4. early postoperative usage.
Our findings suggest the following solutions to the individual issues: 1. Administration at a rate below 0.1 g/kg/hour is generally recommended, but faster administration is possible if necessary, depending on the case, 2. Administration from a piggy tube to basic infusion formulations poses no issues, 3. When administering to critically ill patients, second and third-generation fat emulsions are safe, but soybean oil should be applied cautiously, and 4. Fat emulsion administration immediately after surgery is possible, but considering endogenous energy mobilization, it is advisable to commence from the 3rd to 4th day onwards. The provisional conclusions of this study are as follows: 1. The introduction of medium-chain triglyceride formulations and fish oil (second and third-generation lipid emulsions), which are not currently available in Japan, is urgently needed, and 2. Individualized administration is necessary due to significant individual differences regarding their usage.
