Related Experiment Video

Updated: Jun 5, 2026

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Published on: September 20, 2019

Does delaying early intravenous fat emulsion during parenteral nutrition reduce infections during critical illness?

Anthony T Gerlach¹, Sheela Thomas, Claire V Murphy

¹Department of Pharmacy, The Ohio State University Medical Center, 410 West Tenth Avenue, Columbus, OH, USA. Gerlach.6@osu.edu

Surgical Infections

|December 21, 2010

Abstract

Background:

Because early administration of intravenous fat emulsions (IVFEs) has been linked to infectious complications in trauma patients, we began withholding IVFE for the first seven to ten days of parenteral nutrition (PN) in all surgical intensive care unit (SICU) patients. Prior to this, IVFE had been infused from the start of PN.

Purpose:

To evaluate the influence of delaying IVFE on infectious complications in SICU patients.

Methods:

Retrospective review from October 2006 to June 2009 of SICU patients before and after a change in IVFE practice patterns in a 44-bed SICU at an academic medical center. Adult patients who received PN for more than six days were included. Patients receiving PN with IVFE prior to SICU admission or being given other lipid emulsion therapy were excluded. The data collected included demographics, transfusion requirements, nutritional assessments, and laboratory and microbiology results. The infectious complications studied were pneumonia, urinary tract infections (UTIs), blood stream infections (BSIs), and catheter-related blood stream infections (CRBSIs).

Results:

Sixty-four patients received IVFE; 30 at initiation of PN and 34 starting after seven to ten days. The two groups had similar demographics, severity of illness, transfusion requirements, and duration of PN. Infectious complications occurred in 65.6% of patients (63.3% having immediate IVFE vs. 67.6% having delayed IVFE; p = 0.79). Seventeen patients developed BSI or CRBSI while receiving PN (26.7% immediate IVFE vs. 26.5% delayed IVFE; p > 0.99). The mortality rates were 63.3% and 55.9%, respectively (p = 0.63).

Conclusions:

Withholding IVFE therapy during the first seven to ten days of PN did not influence infectious complications or the mortality rate in SICU patients. The benefits of delaying IVFE therefore may not be generalizable to all critically ill patients.

More Related Videos

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers

Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers

Published on: July 28, 2022

Related Concept Videos

Parentral Nutrition: Centeral and Peripheral Parental Nutrition

Parentral Nutrition: Centeral and Peripheral Parental Nutrition

Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...

Routes of Drug Administration: Parenteral

Routes of Drug Administration: Parenteral

The administration of drugs via parenteral routes allows for direct drug introduction into the systemic circulation, resulting in high bioavailability because the medication bypasses the harsh conditions of the gastrointestinal tract and hepatic metabolism.
The intravenous route (IV) of drug administration can be further categorized into two types. The bolus injection administers the entire dose rapidly, while an intravenous infusion slowly delivers smaller doses steadily.
The IV route is often...

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...

Drug Delivery: Parenteral Route

Drug Delivery: Parenteral Route

The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding

Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding

Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...

Enteral Nutrition I: Orogastric and Nasogastric Feeding

Enteral Nutrition I: Orogastric and Nasogastric Feeding

Enteral nutrition delivers nutrients directly to the stomach or small intestine through a tube. This method is appropriate for patients who cannot eat but still have a functioning digestive system. It is also beneficial for individuals with swallowing difficulties, anorexia, malabsorption, or those who have undergone gastrointestinal (GI) surgery.
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...

Articles linked to this work by shared authors, journal, and citation graph.

MAPK-activated protein kinase 2 orchestrates memory T-cell inflation in cytomegalovirus infection.

Journal of immunology (Baltimore, Md. : 1950)·2026

IDH1-R132H enhances oncolytic HSV-1 therapy by facilitating viral entry and immune activation in glioma.

Nature communications·2026

ED discharge after trauma transfer has increased over time: A single tertiary care center analysis.

Injury·2026

Facilitating interprofessional collaboration for effective care transitions of a patient with chronic obstructive pulmonary disease.

Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition·2026

MAPKAP Kinase 2 Orchestrates Memory T Cell Inflation in Cytomegalovirus Infection.

bioRxiv : the preprint server for biology·2026

Behavioral Economic and Staffing Strategies To Increase Adoption of the ABCDEF Bundle in the Intensive Care Unit (BEST ICU): study protocol for a multi-site stepped-wedge cluster randomized controlled trial in the USA.

Trials·2025

See all related articles