Fat Emulsions

Indications & Dose:

Source of calories adjunctive to TPN.
Adults: 1 ml/minute W. for 15 to 30 minutes (10% emulsion). Infuse only 500 ml the first day Or, 0.5 ml/minute IN. for 15 to 30 minutes (20% emulsion). Infuse only 250 ml of 20% Liposyn emulsion or 500 ml of 20% Intralipid emulsion the first day If no adverse reactions occur, increase rate to deliver 500 ml over 4 to 8 hours. Total daily dose shouldn’t exceed 2.5g/kg (10% emulsion) and 3 g/kg (20% emulsion).
Children: 0.1 ml/minute for 10 to 15 minutes (10% emulsion). Or, 0.05 ml/minute W. for 10 to 15 minutes (20% emulsion). If no adverse reactions occur, increase rate to deliver 1 g/kg over 4 hours. Daily dose shouldn’t exceed 4 g/kg, which equals 60% of daily caloric intake. P rotei n-carbo hydrate TPN should supply remaining 40%. •
Fatty acid deficiency.
Adults and children: 8% to 10% of total caloric intake I.V.
DOSE Usually 50gm, of fat/day/person by IV drip infusion. Maximum dose, 2gm, of fat/kg, body weight per day. Infusion rate. Not more than 50gm of fat per 3-4 hours.

Contraindications:

Contraindicated in patients with hyperlipidemia, lipid nephrosis, acute pancreatitis accompanied by hyperlipidemia, or severe egg allergies. Use cautiously in patients with severe hepatic disease, pulmonary disease, anemia, or blood coagulation disorders (especially thrombocytopenia) and in those at risk for fat embolism. 

Side Effects:

Cautions:

Precautions:

Interaction:

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Early reactions to fat overload
CNS: dizziness, fever, headache, sleepiness.
CV: flushing.
EENT: pressure over eyes.
GI: nausea, vomiting.
Hematologic: hypercoagulability.
Metabolic: hyperlipidemia.
Musculoskeletal: chest and back pain.
Respiratory: cyanosis, dyspnea. Skin: diaphoresis, irritation (at infusion site).
Other: hypersensitivity reactions. Delayed reactions to fat overload
CNS: focal seizures. Hematologic: leukocytosis, leukopenia, thrombocytopenia. Hepatic: hepatomegaly.
Other: splenomegaly.
Effects on lab test results * May increase lipid, bilirubin, and liver enzyme levels. * May decrease platelet count. May increase or decrease WBC count. * May cause abnormally high mean corpuscular hemoglobin levels and mean corpuscular hemoglobin concentration values in blood samples drawn during or shortly after fat emulsion infusion

Patient And Carer Advice: