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ASPEN Lipid Injectable Emulsion Safety Recommendations, Part 1: Background and Adult Considerations
Jay M Mirtallo1,2, Phil Ayers3, Joseph Boullata4
1The American Society for Parenteral and Enteral Nutrition, Silver Spring, Maryland, USA.
Summary
New lipid injectable emulsions (ILEs) offer alternatives to traditional soybean oil formulations, addressing safety concerns and shortages. This guide provides essential information for safe adult use, focusing on indications, dosing, and error prevention.
Area of Science:
- Pharmaceutical Sciences
- Clinical Nutrition
Background:
- Lipid injectable emulsions (ILEs) are critical for parenteral nutrition, providing energy and fatty acids.
- Traditional soybean oil-based ILEs face challenges including safety concerns and product shortages.
- Emerging ILE formulations necessitate updated guidance for clinical practice.
Purpose of the Study:
- To provide comprehensive information on appropriate indications and dosing for ILEs in adult patients.
- To outline methods for avoiding potential prescribing, compounding, and administration errors with ILE products.
- To serve as a foundational resource for safe ILE utilization in the US.
Main Methods:
- Review of current literature and clinical guidelines on ILEs.
- Analysis of safety data and inventory trends for ILE products.
- Development of evidence-based recommendations for clinical practice.
Main Results:
- Identified key differences in ILE issues compared to oral fat, including emulsion stability, dose, and infusion tolerance.
- Highlighted safety concerns and persistent inventory shortages associated with soybean oil-based ILEs.
- Emphasized the need for updated best practices to mitigate risks in ILE use.
Conclusions:
- New ILE products are available, offering alternatives to address limitations of older formulations.
- Adherence to appropriate indications, dosing, and error-avoidance strategies is crucial for safe ILE use in adults.
- This paper (Part 1) focuses on adult patients, with Part 2 addressing pediatric and neonatal populations.
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