[Efficacy of parenterally administered fat emulsions]

Efficiency and tolerance of parenteral fat emulsions are determined essentially by the fate of the fat particles after entry into the circular system. - Although small quantitatively, unwanted phagocytosis by the reticulo endothelial system which may occur must not be disregarded and may lower the state of resistance of the organism. However, the plasma is mainly cleared of emulgated fat by extracellular liberation of fatty acids, the smaller part of which is oxidized immediately, the major part being reesterified to storage fat in adipose tissues by energy requiring process. - In order to avoid an "overloading syndrome" because of saturation of these mechanisms-which is easily possible-recommended dosages must not be exceeded (up to 30% of total daily calories in normal adults, up to 50% in infants, maximum infusion rate 150 mg/kg body weight and hour). - Achievable efficiencies of parenteral fat emulsions can be preestimated roughly depending on parameters of the individual cases. The most important ones among these parameters are the amount and the differently activated intracellular mobilisation of the body's own fat stores in relation to its oxidative capacity or requirement, resp. The indications which result from the efficiencies estimated individually are identical from the viewpoints of application of essential fatty acids as well as of fat emulsions as a calorie source (figure 7a and b).