Significance of eicosapentaenoic acid (EPA) in nutritional support

Changes in the fatty acid profile of plasma total lipids in patients maintained on TPN were determined in 2 studies. In the first study, 20 newborns, 2-25 days of age, receiving comparable nitrogen, calories and fat were divided into 2 groups of 10 in each. A safflower oil emulsion (Liposyn 20%) containing no alpha-linolenic acid was given to the Group 1 subjects, while a modified emulsion containing 3% of alpha-linolenic acid in safflower oil supplying 5.6% of total calories was given to those of Group 2. Plasma alpha-linolenic acid of the Group 1 infants was 0 throughout. The decrease in EPA and DHA was 85% and 65%, respectively, after 10-15 days of therapy. In the subjects of Group 2, there was an increase in both alpha-linolenic acid and EPA. A similar decrease (63%) in DHA similar to that of Group 1 infants was observed. In the second study, results of 2 representative adult patients are reported. One patient was given a soybean oil emulsion (Intralipid, 10%) that contains 7-8% of alpha-linolenic acid in the oil, furnishing about 11% of total calories. The other patient received a safflower oil emulsion (Liposyn, 10%) that contains no alpha-linolenic acid. Each patient received 500 ml of the respective emulsion daily for 3 weeks. The plasma alpha-linolenic acid of the patient who received the safflower oil emulsion remained 0 throughout. EPA showed a 67% decrease in 21 days. DHA remained at low levels throughout.(ABSTRACT TRUNCATED AT 250 WORDS)