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KMID : 0869620130300050415
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Journal of Korean Society of Hospital Pharmacists
2013 Volume.30 No. 5 p.415 ~ p.425
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The Effect of an Intravenous Fat Emulsion Composed of Fish Oil on Hypertriglyceridemia Patients Receiving Total Parenteral Nutrition
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Kwon Ji-Eun
Oh So-Young
Park Ae-Ryoung
Kim Soon-Joo
La Hyen-O
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Abstract
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Intravenous fat emulsion (IVFE) in parenteral nutrition (PN) has an advantage of slipplying essential fatty acids with non-glucose based energy. However, it has been associated with the development of hypertriglyceridemia. The principal management of PN-dependent patients with hypertriglyceridemia is to withhold the IVFE until serum triglyceride (TG) level is normalized. This practice may predispose patients to the development of essential fatty acid deficiency. This study evaluated the effects of fish oil fatty acids on TG levels and liver toxicity in PN dependent hypertriglyceridemia patients. This study included patients who developed TG levels > 400 mg/dL with soybean oil emulsion and then fish oil emulsion in their PN from October 2010 to April 2012 at Seoul St. Mary’s Hospital. The study investigated the differences in TG, aspartate transaminase (AST), alanine transaminase (ALT) and total bilirubin (TB) before and after the regimen change, and evaluated the significance of the differences. A total of 10 patients (6 adults and 4 children) were included. After administration of fish oil IVFE, the average serum TG level was decreased from 451 mg/dL to 250 mg/dL, and this was statistically significanthly different (P=0.006). The average serum AST was increased from 40.5 IU/L to 54.0 IU/L (P=0.910), but the average serum ALT was decreased from 33.5 IU/L to 26.5 IU/L (P=0.508). The average serum TB was increased from 0.7 mg/dL to 0.9 mg/dL (P=0.432). These results showed no statistically significant differences. In conclusion, this study suggests that PN with fish oil emulsion may result in an effective decrease in TG levels. Changes in the liver somatic index did not show statistically significant results. Therefore, we can presume that increased risk of hepatotoxicity did not occur. In order to achieve more accurate and reliable results, it is necessary to conduct randomized controlled trials for evaluating hepatotoxicity of fish oil fatty acids.
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KEYWORD
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Total parenteral nutrition, Hypertriglyceridemia, Fish oil
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