Skip to main content
SpringerLink
Log in

New Uses for a New Oil: Clinical Applications of Fish Oil Lipid Emulsion

  • Nutrition. Metabolism, and Surgery (K Miller, Section Editor)
  • Published:
Current Surgery Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Parenteral nutrition (PN) has been utilized as an essential therapeutic tool in healthcare for more than 5 decades. In United States, the prevalence of home parenteral nutrition (HPN) is estimated to be more than 25,000 patients. Intravenous lipids emulsions (ILEs) are a critically important component of PN as a source of calories and essential fatty acids. In order to provide a deeper understanding of the benefits and risks associated with use of fish oil (FO) containing ILE, this manuscript reviews the history of ILE development, unique benefits of FO, and the clinical data available for FO containing ILEs.

Recent Findings

Over the years, major developments have occurred in order to achieve a nontoxic and stable emulsion. Extensive research and product development led to the development of multiple generations of ILEs. FO containing ILEs, the latest ILE generation, were introduced as safe, effective, and beneficial emulsions with distinct properties and mechanisms of action.

Summary

In this review, we describe ILEs development milestones, biological and metabolic benefits of FO containing ILEs, and key clinical outcome data with consensus key remarks as well as highlighting the challenges in clinical applications and gaps in literature.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Important reference •• Most important reference

  1. Pironi L, Arends J, Bozzetti F, et al. ESPEN guidelines on chronic intestinal failure in adults. Clin Nutr. 2016;35(2):247–307. https://doi.org/10.1016/j.clnu.2016.01.020.

    Article  PubMed  Google Scholar 

  2. Mundi MS, Pattinson A, McMahon MT, Davidson J, Hurt RT. Prevalence of home parenteral and enteral nutrition in the United States. Nutr Clin Pract. 2017;32(6):799–805. https://doi.org/10.1177/0884533617718472.

    Article  PubMed  Google Scholar 

  3. Mundi MS, Klek S, Martindale RG. Use of lipids in adult patients requiring parenteral nutrition in the home setting. J Parenter Enter Nutr. 2020;44(S1):S39–S44. https://doi.org/10.1002/jpen.1755.

    Article  CAS  Google Scholar 

  4. Mundi MS, Salonen BR, Bonnes S. Home parenteral nutrition: fat emulsions and potential complications. Nutr Clin Pract. 2016;31(5):629–41. https://doi.org/10.1177/0884533616663635.

    Article  CAS  PubMed  Google Scholar 

  5. Mundi MS, McMahon MT, Carnell JJ, Hurt RT. Long-term use of mixed-oil lipid emulsion in adult home parenteral nutrition patients: a case series. Nutr Clin Pract. 2018;33(6):851–7. https://doi.org/10.1002/ncp.10014.

    Article  CAS  PubMed  Google Scholar 

  6. Hurt RT, Mundi MS. Use of mixed-oil fat emulsion to improve intestinal failure-associated liver disease in long-term home parenteral nutrition: a case report. JPEN J Parenter Enter Nutr. 2017;41(1_suppl):17S–9S. https://doi.org/10.1177/0148607117741870.

    Article  Google Scholar 

  7. Mundi MS, Salonen BR, Bonnes SL, Hurt RT. Parenteral nutrition–lipid emulsions and potential complications. Pract Gastroenterol. 2017;41:33.

    Google Scholar 

  8. Wanten GJA. Parenteral lipid tolerance and adverse effects: fat chance for trouble? JPEN J Parenter Enter Nutr. 2015;39(1 Suppl):33S–S38. https://doi.org/10.1177/0148607115595973.

    Article  Google Scholar 

  9. Ferezou J, Bach AC. Structure and metabolic fate of triacylglycerol- and phospholipid-rich particles of commercial parenteral fat emulsions1. Nutrition. 1999;15(1):44–50. https://doi.org/10.1016/S0899-9007(98)00130-0.

    Article  CAS  PubMed  Google Scholar 

  10. Mirtallo JM, Dasta JF, Kleinschmidt KC, Varon J. State of the art review: intravenous fat emulsions: current applications, safety profile, and clinical implications. Ann Pharmacother. 2010;44(4):688–700. https://doi.org/10.1345/aph.1M626.

    Article  CAS  PubMed  Google Scholar 

  11. Bach AC, Babayan VK. Medium-chain triglycerides: an update. Am J Clin Nutr. 1982;36(5):950–62.

    Article  CAS  PubMed  Google Scholar 

  12. Mingrone G, De Gaetano A, Greco AV, Capristo E, Castagneto M, Gasbarrini G. Medium-chain triglycerides for parenteral nutrition: kinetic profile in humans. Nutrition. 1995;11(5):418–22.

    CAS  PubMed  Google Scholar 

  13. Courten W, Sloane H. Experiments and observations of the effects of several sorts of poisons upon animals, etc. Made at Montpellier in the years 1678 and 1679, by the Late William Courten Esq; Communicated by Dr. Hans Sloane, R. S. Secr. Translated from the Latin MS. Phil Trans. 1710;27(325–336):485–500. https://doi.org/10.1098/rstl.1710.0054.

  14. Hodder E. Transfusion of milk in cholera. Practitioner. 1873;10:14–6.

    Google Scholar 

  15. Vinnars E, Wilmore D. History of parenteral nutrition. JPEN J Parenter Enter Nutr. 2003;27(3):225–31. https://doi.org/10.1177/0148607103027003225.

    Article  Google Scholar 

  16. van Itallie TB, Waddell WR, Geyer RP, Stare FJ. Clinical use of fat injected intravenously. AMA Arch Intern Med. 1952;89(3):353–7. https://doi.org/10.1001/archinte.1952.00240030002001.

    Article  Google Scholar 

  17. Holt LE, Tidwell HC, McNair Scott TF. The intravenous administration of fat. J Pediatr. 1935;6(2):151–60. https://doi.org/10.1016/S0022-3476(35)80176-5.

    Article  Google Scholar 

  18. Geyer RP, Mann GV, Stare FJ. Parenteral nutrition; improved techniques for the preparation of fat emulsions for intravenous nutrition. J Lab Clin Med. 1948;33(1):153–62.

    CAS  PubMed  Google Scholar 

  19. Vinnars E, Hammarqvist F. 25th Arvid Wretlind’s lecture—silver anniversary, 25 years with ESPEN, the history of nutrition. Clin Nutr. 2004;23(5):955–62. https://doi.org/10.1016/j.clnu.2004.06.001.

    Article  PubMed  Google Scholar 

  20. Slattery E, Rumore MM, Douglas JS, Seres DS. 3-in-1 vs 2-in-1 parenteral nutrition in adults a review. Nutr Clin Pract. 2014;29(5):631–5. https://doi.org/10.1177/0884533614533611.

    Article  PubMed  Google Scholar 

  21. Schubert O, Wretlind A. Intravenous infusion of fat emulsions, phosphatides and emulsifying agents. Acta Chir Scand Suppl. 1961;13:278.

    Google Scholar 

  22. Dudrick SJ, Wilmore DW, Vars HM, Rhoads JE. Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery. 1968;64(1):134–42.

    CAS  PubMed  Google Scholar 

  23. Wilmore DW, Dudrick SJ. GRowth and development of an infant receiving all nutrients exclusively by vein. JAMA. 1968;203(10):860–4. https://doi.org/10.1001/jama.1968.03140100042009.

    Article  CAS  PubMed  Google Scholar 

  24. Dudrick SJ, Macfadyen BV, Van Buren CT, Ruberg RL, Maynard AT. Parenteral hyperalimentation. Metabolic problems and solutions. Ann Surg. 1972;176(3):259–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Grant JP, Cox CE, Kleinman LM, et al. Serum hepatic enzyme and bilirubin elevations during parenteral nutrition. Surg Gynecol Obstet. 1977;145(4):573–80.

    CAS  PubMed  Google Scholar 

  26. Faulkner WJ, Flint LM. Essential fatty acid deficiency associated with total parenteral nutrition. Surg Gynecol Obstet. 1977;144(5):665–7.

    CAS  PubMed  Google Scholar 

  27. Wretlind A. Development of fat emulsions. JPEN J Parenter Enter Nutr. 1981;5(3):230–5.

    Article  CAS  Google Scholar 

  28. Meguid MM, Schimmel E, Johnson WC, et al. Reduced metabolic complications in total parenteral nutrition: pilot study using fat to replace one-third of glucose calories. JPEN J Parenter Enter Nutr. 1982;6(4):304–7.

    Article  CAS  Google Scholar 

  29. Vanek VW, Seidner DL, Allen P, et al. A.S.P.E.N. position paper clinical role for alternative intravenous fat emulsions. Nutr Clin Pract. 2012;27(2):150–92. https://doi.org/10.1177/0884533612439896.

    Article  PubMed  Google Scholar 

  30. Abbasoglu O, Hardy G, Manzanares W, Pontes-Arruda A. Fish oil-containing lipid emulsions in adult parenteral nutrition: a review of the evidence. JPEN J Parenter Enter Nutr. 2017. https://doi.org/10.1177/0148607117721907.

    Article  Google Scholar 

  31. •Calder PC. Use of fish oil in parenteral nutrition: rationale and reality. Proc Nutr Soc. 2006;65(3):264–77. https://doi.org/10.1079/pns2006500. Reference contributed to understanding and conception of use of lipids, particularly FO, in PN, basics of lipids metabolism and immunological/biological aspects. It also provided a comprehensive review of potential clinical application of FO in PN.

  32. Gramlich L, Meddings L, Alberda C, et al. Essential fatty acid deficiency in 2015 the impact of novel intravenous lipid emulsions. JPEN J Parenter Enter Nutr. 2015;39(1 suppl):61S–6S. https://doi.org/10.1177/0148607115595977.

    Article  Google Scholar 

  33. Wanten GJ, Calder PC. Immune modulation by parenteral lipid emulsions. Am J Clin Nutr. 2007;85(5):1171–84.

    Article  CAS  PubMed  Google Scholar 

  34. Tilley SL, Coffman TM, Koller BH. Mixed messages: modulation of inflammation and immune responses by prostaglandins and thromboxanes. J Clin Investig. 2001;108(1):15–23.

    Article  CAS  PubMed  Google Scholar 

  35. Lewis RA. Interactions of eicosanoids and cytokines in immune regulation. Adv Prostaglandin Thromboxane Leukot Res. 1990;20:170–8.

    CAS  PubMed  Google Scholar 

  36. Seidner DL, Mascioli EA, Istfan NW, et al. Effects of long-chain triglyceride emulsions on reticuloendothelial system function in humans. JPEN J Parenter Enter Nutr. 1989;13(6):614–9.

    Article  CAS  Google Scholar 

  37. Cavicchi M, Beau P, Crenn P, Degott C, Messing B. Prevalence of liver disease and contributing factors in patients receiving home parenteral nutrition for permanent intestinal failure. Ann Intern Med. 2000;132(7):525–32. https://doi.org/10.7326/0003-4819-132-7-200004040-00003.

    Article  CAS  PubMed  Google Scholar 

  38. •Mundi MS, Martindale R, Hurt RT. Emergence of mixed-oil fat emulsions for use in parenteral nutrition. JPEN J Parenter Enter Nutr. 2017. https://doi.org/10.1177/0148607117742595. Reference contributed to understanding of conception of use of lipids, particularly FO, in PN, basics of lipids metabolism and immunological/biological aspects. It also provided a comprehensive review of the milestones on ILE development.

  39. Socha P, Koletzko B, Demmelmair H, et al. Short-term effects of parenteral nutrition of cholestatic infants with lipid emulsions based on medium-chain and long-chain triacylglycerols. Nutrition. 2007;23(2):121–6. https://doi.org/10.1016/j.nut.2006.10.009.

    Article  CAS  PubMed  Google Scholar 

  40. Nijveldt RJ, Tan AM, Prins HA, et al. Use of a mixture of medium-chain triglycerides and longchain triglycerides versus long-chain triglycerides in critically ill surgical patients: a randomized prospective double-blind study. Clin Nutr. 1998;17(1):23–9.

    Article  CAS  PubMed  Google Scholar 

  41. Lai H-S, Lin W-H, Wu H-C, Chang K-J, Chen W-J. Effects of a medium-chain triacylglycerol/long-chain triacylglycerol fat emulsion containing a reduced ratio of phospholipid to triacylglycerol in pediatric surgical patients. Nutrition. 2005;21(7–8):825–30. https://doi.org/10.1016/j.nut.2004.11.017.

    Article  CAS  PubMed  Google Scholar 

  42. Kuse ER, Kotzerke J, Müller S, Nashan B, Lück R, Jaeger K. Hepatic reticuloendothelial function during parenteral nutrition including an MCT/LCT or LCT emulsion after liver transplantation—a double-blind study. Transpl Int. 2002;15(6):272–7. https://doi.org/10.1007/s00147-002-0393-1.

    Article  CAS  PubMed  Google Scholar 

  43. Martin-Pena G, Culebras J, De la Hoz-Perales L, Barro-Ordovas J, Catala-Pizarro R, Ruiz-Galiana J. Effects of 2 lipid emulsions (LCT versus MCT/LCT) on the fatty acid composition of plasma phospholipid: a double-blind randomized trial. J Parenter Enter Nutr. 2002;26(1):30–41. https://doi.org/10.1177/014860710202600130.

    Article  CAS  Google Scholar 

  44. Thomas-Gibson S, Jawhari A, Atlan P, Brun AL, Farthing M, Forbes A. Safe and efficacious prolonged use of an olive oil-based lipid emulsion (ClinOleic©) in chronic intestinal failure. Clin Nutr. 2004;23(4):697–703. https://doi.org/10.1016/j.clnu.2003.11.007.

    Article  CAS  PubMed  Google Scholar 

  45. Pálová S, Charvat J, Kvapil M. Comparison of soybean oil- and olive oil-based lipid emulsions on hepatobiliary function and serum triacylglycerols level during realimentation. J Int Med Res. 2008;36(3):587–93. https://doi.org/10.1177/147323000803600326.

    Article  PubMed  Google Scholar 

  46. Siqueira J, Smiley D, Newton C, et al. Substitution of standard soybean oil with olive oil-based lipid emulsion in parenteral nutrition: comparison of vascular, metabolic, and inflammatory effects. J Clin Endocrinol Metab. 2011;96(10):3207–16. https://doi.org/10.1210/jc.2011-0480.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Fell GL, Nandivada P, Gura KM, Puder M. Intravenous lipid emulsions in parenteral nutrition123. Adv Nutr. 2015;6(5):600–10. https://doi.org/10.3945/an.115.009084.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Wichmann MW, Thul P, Czarnetzki H-D, Morlion BJ, Kemen M, Jauch K-W. Evaluation of clinical safety and beneficial effects of a fish oil containing lipid emulsion (Lipoplus, MLF541): data from a prospective, randomized, multicenter trial. Crit Care Med. 2007;35(3):700–6. https://doi.org/10.1097/01.CCM.0000257465.60287.AC.

    Article  PubMed  Google Scholar 

  49. Kromann N, Green A. Epidemiological studies in the Upernavik District Greenland. Acta Med Scand. 1980;208(1–6):401–6. https://doi.org/10.1111/j.0954-6820.1980.tb01221.x.

    Article  CAS  PubMed  Google Scholar 

  50. Harris WS. n-3 fatty acids and lipoproteins: comparison of results from human and animal studies. Lipids. 1996;31(3):243–52. https://doi.org/10.1007/BF02529870.

    Article  CAS  PubMed  Google Scholar 

  51. Connor SL, Connor WE. Are fish oils beneficial in the prevention and treatment of coronary artery disease? Am J Clin Nutr. 1031S;66(4):1020S–31S. https://doi.org/10.1093/ajcn/66.4.1020S.

    Article  CAS  PubMed  Google Scholar 

  52. Wu D, Meydani SN. n-3 Polyunsaturated fatty acids and immune function. Proc Nutr Soc. 1998;57(4):503–9. https://doi.org/10.1079/PNS19980074.

    Article  CAS  PubMed  Google Scholar 

  53. Harbige LS. Dietary n-6 and n-3 fatty acids in immunity and autoimmune disease. Proc Nutr Soc. 1998;57(4):555–62. https://doi.org/10.1079/PNS19980081.

    Article  CAS  PubMed  Google Scholar 

  54. Kelley DS, Daudu PA. Fat intake and immune response. Prog Food Nutr Sci. 1993;17(1):41–63.

    CAS  PubMed  Google Scholar 

  55. Anderson M, Fritsche KL. (n-3) fatty acids and infectious disease resistance. J Nutr. 2002;132(12):3566–76. https://doi.org/10.1093/jn/132.12.3566.

    Article  CAS  PubMed  Google Scholar 

  56. Paul KP, Leichsenring M, Pfisterer M, et al. Influence of n-6 and n-3 polyunsaturated fatty acids on the resistance to experimental tuberculosis. Metabolism. 1997;46(6):619–24. https://doi.org/10.1016/S0026-0495(97)90003-2.

    Article  CAS  PubMed  Google Scholar 

  57. Lichtenstein AH. Remarks on clinical data concerning dietary supplements that affect antithrombotic therapy. Thromb Res. 2005;117(1–2):71–3; discussion 113–115. https://doi.org/10.1016/j.thromres.2005.04.013.

    Article  CAS  PubMed  Google Scholar 

  58. Weitz D, Weintraub H, Fisher E, Schwartzbard AZ. Fish oil for the treatment of cardiovascular disease. Cardiol Rev. 2010;18(5):258–63. https://doi.org/10.1097/CRD.0b013e3181ea0de0.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Knapp HR, Reilly IAG, Alessandrini P, FitzGerald GA. In vivo indexes of platelet and vascular function during fish-oil administration in patients with atherosclerosis. N Engl J Med. 1986;314(15):937–42. https://doi.org/10.1056/NEJM198604103141501.

    Article  CAS  PubMed  Google Scholar 

  60. Knapp HR. Dietary fatty acids in human thrombosis and hemostasis. Am J Clin Nutr. 1698S;65(5):1687S–98S. https://doi.org/10.1093/ajcn/65.5.1687S.

    Article  CAS  PubMed  Google Scholar 

  61. Mayer K, Merfels M, Muhly-Reinholz M, et al. Omega-3 fatty acids suppress monocyte adhesion to human endothelial cells: role of endothelial PAF generation. Am J Physiol Heart Circ Physiol. 2002;283(2):H811–818. https://doi.org/10.1152/ajpheart.00235.2002.

    Article  CAS  PubMed  Google Scholar 

  62. Pontes-Arruda A. Using parenteral fish oil to modulate inflammatory response. J Parenter Enter Nutr. 2010;34(3):344–5. https://doi.org/10.1177/0148607109348063.

    Article  Google Scholar 

  63. Heyland DK, Novak F, Drover JW, Jain M, Su X, Suchner U. Should immunonutrition become routine in critically ill patients?: A systematic review of the evidence. JAMA. 2001;286(8):944–53. https://doi.org/10.1001/jama.286.8.944.

    Article  CAS  PubMed  Google Scholar 

  64. Carpentier YA, Dupont IE. Advances in intravenous lipid emulsions. World J Surg. 2000;24(12):1493–7. https://doi.org/10.1007/s002680010267.

    Article  CAS  PubMed  Google Scholar 

  65. Calder PC. Mechanisms of action of (n-3) fatty acids. J Nutr. 2012;142(3):592S–9S. https://doi.org/10.3945/jn.111.155259.

    Article  CAS  PubMed  Google Scholar 

  66. Calder PC. Rationale and use of n-3 fatty acids in artificial nutrition. Proc Nutr Soc. 2010;69(4):565–73. https://doi.org/10.1017/S0029665110000157.

    Article  CAS  PubMed  Google Scholar 

  67. Klek S, Chambrier C, Singer P, et al. Four-week parenteral nutrition using a third generation lipid emulsion (SMOFlipid)—a double-blind, randomised, multicentre study in adults. Clin Nutr. 2013;32(2):224–31. https://doi.org/10.1016/j.clnu.2012.06.011.

    Article  CAS  PubMed  Google Scholar 

  68. Dai Y-J, Sun L-L, Li M-Y, et al. Comparison of formulas based on lipid emulsions of olive oil, soybean oil, or several oils for parenteral nutrition: a systematic review and meta-analysis. Adv Nutr. 2016;7(2):279–86. https://doi.org/10.3945/an.114.007427.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  69. •Serhan CN. Novel pro-resolving lipid mediators in inflammation are leads for resolution physiology. Nature. 2014;510(7503):92–101. https://doi.org/10.1038/nature13479. Reference contributed to understanding of conception of use of lipids, particularly FO, in PN, and relatively newer ideas on pro-solution and SPMs effect.

  70. Rajasagi NK, Reddy PBJ, Suryawanshi A, Mulik S, Gjorstrup P, Rouse BT. Controlling herpes simplex virus-induced ocular inflammatory lesions with the lipid-derived mediator resolvin E1. J Immunol. 2011;186(3):1735–46. https://doi.org/10.4049/jimmunol.1003456.

    Article  CAS  PubMed  Google Scholar 

  71. Dalli J, Colas RA, Quintana C, et al. Human sepsis eicosanoid and pro-resolving lipid mediator temporal profiles: correlations with survival and clinical outcomes. Crit Care Med. 2017;45(1):58–68. https://doi.org/10.1097/CCM.0000000000002014.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Chiang N, Fredman G, Bäckhed F, et al. Infection regulates pro-resolving mediators that lower antibiotic requirements. Nature. 2012;484(7395):524–8. https://doi.org/10.1038/nature11042.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. •Calder PC, Waitzberg DL, Klek S, Martindale RG. Lipids in parenteral nutrition: biological aspects. J Parenter Enter Nutr. 2020;44(S1):S21–S2727. https://doi.org/10.1002/jpen.1756. Reference contributed to understanding of conception of use of lipids, particularly FO, in PN, basics of lipids metabolism, at its immunological/biological aspects.

  74. von Schacky C. Cardiovascular disease prevention and treatment. Prostaglandins Leukot Essent Fatty Acids. 2009;81(2):193–8. https://doi.org/10.1016/j.plefa.2009.05.009.

    Article  CAS  Google Scholar 

  75. Breslow JL. n−3 fatty acids and cardiovascular disease. Am J Clin Nutr. 1482S;83(6):1477S–82S. https://doi.org/10.1093/ajcn/83.6.1477S.

    Article  CAS  PubMed  Google Scholar 

  76. Pan M, Maitin V, Parathath S, et al. Presecretory oxidation, aggregation, and autophagic destruction of apoprotein-B: a pathway for late-stage quality control. PNAS. 2008;105(15):5862–7. https://doi.org/10.1073/pnas.0707460104.

    Article  PubMed  Google Scholar 

  77. Park Y, Harris WS. Omega-3 fatty acid supplementation accelerates chylomicron triglyceride clearance. J Lipid Res. 2003;44(3):455–63. https://doi.org/10.1194/jlr.M200282-JLR200.

    Article  CAS  PubMed  Google Scholar 

  78. Weintraub MS, Zechner R, Brown A, Eisenberg S, Breslow JL. Dietary polyunsaturated fats of the W-6 and W-3 series reduce postprandial lipoprotein levels. Chronic and acute effects of fat saturation on postprandial lipoprotein metabolism. J Clin Investig. 1988;82(6):1884–933. https://doi.org/10.1172/JCI113806.

    Article  CAS  PubMed  Google Scholar 

  79. Klek S. Omega-3 fatty acids in modern parenteral nutrition: a review of the current evidence. J Clin Med. 2016. https://doi.org/10.3390/jcm5030034.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Calder PC. Hot topics in parenteral nutrition. Rationale for using new lipid emulsions in parenteral nutrition and a review of the trials performed in adults. Proc Nutr Soc. 2009;68(3):252–60. https://doi.org/10.1017/S0029665109001268.

    Article  CAS  PubMed  Google Scholar 

  81. ••Martindale RG, Berlana D, Boullata JI, et al. Summary of proceedings and expert consensus statements from the international summit “lipids in parenteral nutrition”. J Parenter Enter Nutr. 2020;44(S1):S7–S20. https://doi.org/10.1002/jpen.1746. Reference contributed to understanding of most recent review of evidence and consensus opinions from PN community on clinical applications of FO in PN.

  82. Heller AR, Rössler S, Litz RJ, et al. Omega-3 fatty acids improve the diagnosis-related clinical outcome. Crit Care Med. 2006;34(4):972–9. https://doi.org/10.1097/01.CCM.0000206309.83570.45.

    Article  CAS  PubMed  Google Scholar 

  83. Tsekos E, Reuter C, Stehle P, Boeden G. Perioperative administration of parenteral fish oil supplements in a routine clinical setting improves patient outcome after major abdominal surgery. Clin Nutr. 2004;23(3):325–30. https://doi.org/10.1016/j.clnu.2003.07.008.

    Article  CAS  PubMed  Google Scholar 

  84. McClave SA, Taylor BE, Martindale RG, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient society of critical care medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enter Nutr. 2016;40(2):159–21111. https://doi.org/10.1177/0148607115621863.

    Article  CAS  Google Scholar 

  85. ••Pradelli L, Mayer K, Klek S, et al. ω-3 fatty-acid enriched parenteral nutrition in hospitalized patients: systematic review with meta-analysis and trial sequential analysis. J Parenter Enter Nutr. 2020;44(1):44–57. https://doi.org/10.1002/jpen.1672. Reference contributed to understanding of most recent review of evidence and consensus opinions from PN community on clinical applications of FO in PN.

  86. Li N-N, Zhou Y, Qin X-P, et al. Does intravenous fish oil benefit patients post-surgery? A meta-analysis of randomised controlled trials. Clin Nutr. 2014;33(2):226–39. https://doi.org/10.1016/j.clnu.2013.08.013.

    Article  CAS  PubMed  Google Scholar 

  87. Grau-Carmona T, Bonet-Saris A, García-de-Lorenzo A, et al. Influence of n-3 polyunsaturated fatty acids enriched lipid emulsions on nosocomial infections and clinical outcomes in critically ill patients: ICU lipids study. Crit Care Med. 2015;43(1):31–9. https://doi.org/10.1097/CCM.0000000000000612.

    Article  CAS  PubMed  Google Scholar 

  88. Zhang B, Wei G, Li R, et al. n-3 fatty acid-based parenteral nutrition improves postoperative recovery for cirrhotic patients with liver cancer: a randomized controlled clinical trial. Clin Nutr. 2017. https://doi.org/10.1016/j.clnu.2016.08.002.

    Article  PubMed  Google Scholar 

  89. Anis Metry A, Abdelaal W, Ragaei M, Refaat M, Nakhla G. SMOFlipid versus intralipid in postoperative ICU patients. Enliven: J Anesthesiol Crit Care Med. 2014. https://doi.org/10.18650/2374-4448.16015.

    Article  Google Scholar 

  90. Premkumar MH, Carter BA, Hawthorne KM, King K, Abrams SA. Fish oil–based lipid emulsions in the treatment of parenteral nutrition-associated liver disease: an ongoing positive experience123. Adv Nutr. 2014;5(1):65–70. https://doi.org/10.3945/an.113.004671.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Burns DL, Gill BM. Reversal of parenteral nutrition–associated liver disease with a fish oil–based lipid emulsion (omegaven) in an adult dependent on home parenteral nutrition. JPEN J Parenter Enter Nutr. 2013;37(2):274–80. https://doi.org/10.1177/0148607112450301.

    Article  CAS  Google Scholar 

  92. Heller AR, Rössel T, Gottschlich B, et al. Omega-3 fatty acids improve liver and pancreas function in postoperative cancer patients: omega-3 fatty acid after cancer surgery. Int J Cancer. 2004;111(4):611–6. https://doi.org/10.1002/ijc.20291.

    Article  CAS  PubMed  Google Scholar 

  93. Wu M-H, Wang M-Y, Yang C-Y, Kuo M-L, Lin M-T. Randomized clinical trial of new intravenous lipid (SMOFlipid 20%) versus medium-chain triglycerides/long-chain triglycerides in adult patients undergoing gastrointestinal surgery. JPEN J Parenter Enter Nutr. 2014;38(7):800–8. https://doi.org/10.1177/0148607113512869.

    Article  CAS  Google Scholar 

  94. Lam HS, Tam YH, Poon TCW, et al. A double-blind randomised controlled trial of fish oil-based versus soy-based lipid preparations in the treatment of infants with parenteral nutrition-associated cholestasis. Neonatology. 2014;105(4):290–6. https://doi.org/10.1159/000358267.

    Article  CAS  PubMed  Google Scholar 

  95. Gura KM, Duggan CP, Collier SB, et al. Reversal of parenteral nutrition–associated liver disease in two infants with short bowel syndrome using parenteral fish oil: implications for future management. Pediatrics. 2006;118(1):e197–e201. https://doi.org/10.1542/peds.2005-2662.

    Article  PubMed  Google Scholar 

  96. Gura KM, Parsons SK, Bechard LJ, et al. Use of a fish oil-based lipid emulsion to treat essential fatty acid deficiency in a soy allergic patient receiving parenteral nutrition. Clin Nutr. 2005;24(5):839–47. https://doi.org/10.1016/j.clnu.2005.05.020.

    Article  CAS  PubMed  Google Scholar 

  97. Lee SI, Valim C, Johnston P, et al. Impact of fish oil-based lipid emulsion on serum triglyceride, bilirubin, and albumin levels in children with parenteral nutrition-associated liver disease. Pediatr Res. 2009;66(6):698–703. https://doi.org/10.1203/PDR.0b013e3181bbdf2b.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Funding

No financial disclosure to report.

Author information

Authors and Affiliations

  1. Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Osman Mohamed Elfadil, Saketh Vellapati, Janki Patel, Ramya Narasimhan, Ryan T. Hurt & Manpreet S. Mundi

  2. Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Sara L. Bonnes, Bradley R. Salonen & Ryan T. Hurt

  3. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

    Ryan T. Hurt

  4. Division of Gastroenterology, Hepatology and Nutrition, University of Louisville, Louisville, KY, USA

    Ryan T. Hurt

Authors
  1. Osman Mohamed Elfadil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sara L. Bonnes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bradley R. Salonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Saketh Vellapati
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Janki Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ramya Narasimhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ryan T. Hurt
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Manpreet S. Mundi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Manpreet S. Mundi.

Ethics declarations

Conflict of interest

Ryan T. Hurt is a consultant for Nestle. Manpreet S. Mundi has an unrestricted investigator-initiated research grant from Fresenius Kabi, Nestle, and Realfood blends and is a consultant for Baxter. Osman Mohamed Elfadil, Saketh Vellapati, Janki Patel, Ramya Narasimhan, Sara L. Bonnes, and Bradley R. Salonen have no financial disclosure or conflict of interest to report.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Nutrition, Metabolism, and Surgery.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mohamed Elfadil, O., Bonnes, S.L., Salonen, B.R. et al. New Uses for a New Oil: Clinical Applications of Fish Oil Lipid Emulsion. Curr Surg Rep 8, 16 (2020). https://doi.org/10.1007/s40137-020-00259-1

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s40137-020-00259-1

Keywords

Search

Navigation