Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical Applications
Lipid emulsions (LEs), an integral component in parenteral nutrition (PN) feeding, have shifted from the primary aim of delivering non-protein calories and essential fatty acids to defined therapeutic outcomes such as reducing inflammation, and improving metabolic and clinical outcomes. Use of LEs i...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-04-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphar.2020.00506/full |
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| author | Birinder Kaur Sadu Singh Sreelakshmi Sankara Narayanan Ban Hock Khor Sharmela Sahathevan Abdul Halim Abdul Gafor Enrico Fiaccadori Kalyana Sundram Tilakavati Karupaiah |
| author_facet | Birinder Kaur Sadu Singh Sreelakshmi Sankara Narayanan Ban Hock Khor Sharmela Sahathevan Abdul Halim Abdul Gafor Enrico Fiaccadori Kalyana Sundram Tilakavati Karupaiah |
| author_sort | Birinder Kaur Sadu Singh |
| collection | DOAJ |
| description | Lipid emulsions (LEs), an integral component in parenteral nutrition (PN) feeding, have shifted from the primary aim of delivering non-protein calories and essential fatty acids to defined therapeutic outcomes such as reducing inflammation, and improving metabolic and clinical outcomes. Use of LEs in PN for surgical and critically ill patients is particularly well established, and there is enough literature assigning therapeutic and adverse effects to specific LEs. This narrative review contrarily puts into perspective the fatty acid compositional (FAC) nature of LE formulations, and discusses clinical applications and outcomes according to the biological function and structural functionality of fatty acids and co-factors such as phytosterols, α-tocopherol, emulsifiers and vitamin K. In addition to soybean oil-based LEs, this review covers clinical studies using the alternate LEs that incorporates physical mixtures combining medium- and long-chain triglycerides or structured triglycerides or the unusual olive oil or fish oil. The Jaded score was applied to assess the quality of these studies, and we report outcomes categorized as per immuno-inflammatory, nutritional, clinical, and cellular level FAC changes. It appears that the FAC nature of LEs is the primary determinant of desired clinical outcomes, and we conclude that one type of LE alone cannot be uniformly applied to patient care. |
| first_indexed | 2024-12-13T16:03:40Z |
| format | Article |
| id | doaj.art-a1e1afe8f6bf40cface32a3d2b770dbc |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-13T16:03:40Z |
| publishDate | 2020-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-a1e1afe8f6bf40cface32a3d2b770dbc2022-12-21T23:39:06ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122020-04-011110.3389/fphar.2020.00506476933Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical ApplicationsBirinder Kaur Sadu Singh0Sreelakshmi Sankara Narayanan1Ban Hock Khor2Sharmela Sahathevan3Abdul Halim Abdul Gafor4Enrico Fiaccadori5Kalyana Sundram6Tilakavati Karupaiah7Nutrition Programme, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, MalaysiaFaculty of Health & Medical Science, School of BioSciences, Taylor’s University Lakeside Campus, Selangor, MalaysiaDietetics Programme, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, MalaysiaDietetics Programme, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, MalaysiaMedical Department, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, MalaysiaAcute and Chronic Renal Failure Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, ItalyMalaysian Palm Oil Council (MPOC), Petaling Jaya, MalaysiaFaculty of Health & Medical Science, School of BioSciences, Taylor’s University Lakeside Campus, Selangor, MalaysiaLipid emulsions (LEs), an integral component in parenteral nutrition (PN) feeding, have shifted from the primary aim of delivering non-protein calories and essential fatty acids to defined therapeutic outcomes such as reducing inflammation, and improving metabolic and clinical outcomes. Use of LEs in PN for surgical and critically ill patients is particularly well established, and there is enough literature assigning therapeutic and adverse effects to specific LEs. This narrative review contrarily puts into perspective the fatty acid compositional (FAC) nature of LE formulations, and discusses clinical applications and outcomes according to the biological function and structural functionality of fatty acids and co-factors such as phytosterols, α-tocopherol, emulsifiers and vitamin K. In addition to soybean oil-based LEs, this review covers clinical studies using the alternate LEs that incorporates physical mixtures combining medium- and long-chain triglycerides or structured triglycerides or the unusual olive oil or fish oil. The Jaded score was applied to assess the quality of these studies, and we report outcomes categorized as per immuno-inflammatory, nutritional, clinical, and cellular level FAC changes. It appears that the FAC nature of LEs is the primary determinant of desired clinical outcomes, and we conclude that one type of LE alone cannot be uniformly applied to patient care.https://www.frontiersin.org/article/10.3389/fphar.2020.00506/fullfatty acidslipid emulsionstriglyceridestriacylglycerolsparenteral nutrition |
| spellingShingle | Birinder Kaur Sadu Singh Sreelakshmi Sankara Narayanan Ban Hock Khor Sharmela Sahathevan Abdul Halim Abdul Gafor Enrico Fiaccadori Kalyana Sundram Tilakavati Karupaiah Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical Applications Frontiers in Pharmacology fatty acids lipid emulsions triglycerides triacylglycerols parenteral nutrition |
| title | Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical Applications |
| title_full | Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical Applications |
| title_fullStr | Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical Applications |
| title_full_unstemmed | Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical Applications |
| title_short | Composition and Functionality of Lipid Emulsions in Parenteral Nutrition: Examining Evidence in Clinical Applications |
| title_sort | composition and functionality of lipid emulsions in parenteral nutrition examining evidence in clinical applications |
| topic | fatty acids lipid emulsions triglycerides triacylglycerols parenteral nutrition |
| url | https://www.frontiersin.org/article/10.3389/fphar.2020.00506/full |
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