PMID- 20332339
OWN - NLM
STAT- MEDLINE
DCOM- 20100615
LR  - 20220408
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 44
IP  - 4
DP  - 2010 Apr
TI  - State of the art review: Intravenous fat emulsions: Current applications, safety 
      profile, and clinical implications.
PG  - 688-700
LID - 10.1345/aph.1M626 [doi]
AB  - OBJECTIVE: To review the current state of the science regarding intravenous fat 
      emulsions (IVFEs), with an emphasis on their safety profile. DATA SOURCES: 
      Articles were identified via a search of the MEDLINE database, including 
      publications from 1979 to December 2009, using a search string that included the 
      terms parenteral nutrition, lipid emulsion, fat emulsion, IVFE, safety, adverse 
      effect, neonate intralipid, and terms describing a range of specific adverse 
      events (AEs) such as pancreatitis. STUDY SELECTION AND DATA EXTRACTION: We 
      selected articles that allowed us to compare the results of clinical trials 
      involving delivery of medications via IVFEs with the historical use and effects 
      of IVFEs in parenteral nutrition, with an emphasis on AEs. We focused on 2 drugs 
      in current use that are administered intravenously in lipid emulsions: propofol 
      and clevidipine. DATA SYNTHESIS: Clearance of the fat particles in IVFEs is 
      mediated by the enzyme lipoprotein lipase. AEs are more likely if the rate or 
      duration of IVFE administration exceeds the enzyme's clearance capacity. AEs are 
      also more likely after administration of a 10% IVFE formulation than a 20% 
      formulation, because the higher concentration of free phospholipid in the 10% 
      formulation interferes with lipoprotein lipase activity. AEs can be reduced by 
      administering IVFEs at a dosage < or = 2.5 g/kg/day and at a rate < or = 0.11 
      g/kg/h. The anesthetic agent propofol, which is formulated in a 10% IVFE, has 
      been used clinically for 25 years. Typical AEs associated with propofol use 
      include infection, high plasma triglyceride concentrations, and pancreatitis. 
      Recent clinical trials involving clevidipine, which is formulated in a 20% IVFE, 
      have demonstrated a low rate of lipid-related AEs. CONCLUSIONS: The results of 
      this review demonstrate that IVFEs are well tolerated when administered in 
      accordance with guideline recommendations.
FAU - Mirtallo, Jay M
AU  - Mirtallo JM
AD  - Department of Pharmacy, The Ohio State University Medical Center, Columbus, USA. 
      jay.mirtallo@osumc.edu
FAU - Dasta, Joseph F
AU  - Dasta JF
FAU - Kleinschmidt, Kurt C
AU  - Kleinschmidt KC
FAU - Varon, Joseph
AU  - Varon J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anticoagulants)
RN  - 0 (Antidotes)
RN  - 0 (Fat Emulsions, Intravenous)
RN  - 12001-79-5 (Vitamin K)
SB  - IM
MH  - Anticoagulants/adverse effects
MH  - Antidotes/therapeutic use
MH  - Bacteria/drug effects/growth & development
MH  - Drug Delivery Systems
MH  - Drug Interactions
MH  - Drug Overdose
MH  - Fat Emulsions, Intravenous/adverse effects/chemistry/*therapeutic use
MH  - Humans
MH  - Hypertriglyceridemia/etiology
MH  - Immune System/drug effects
MH  - Infant, Newborn
MH  - Infant, Premature
MH  - Infant, Small for Gestational Age
MH  - Liver Function Tests
MH  - Pancreatitis/etiology
MH  - *Parenteral Nutrition
MH  - Respiratory Function Tests
MH  - Vitamin K/antagonists & inhibitors
RF  - 102
EDAT- 2010/03/25 06:00
MHDA- 2010/06/16 06:00
CRDT- 2010/03/25 06:00
PHST- 2010/03/25 06:00 [entrez]
PHST- 2010/03/25 06:00 [pubmed]
PHST- 2010/06/16 06:00 [medline]
AID - aph.1M626 [pii]
AID - 10.1345/aph.1M626 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2010 Apr;44(4):688-700. doi: 10.1345/aph.1M626.