Use of Fish Oil Intravenous Lipid Emulsions as Monotherapy in the Pediatric Intestinal Failure Patient: Beyond the Package Insert.

Abstract

In July 2018, an intravenous lipid emulsion (ILE) composed of 100% fish oil (Omegaven, Fresenius Kabi, Bad Homburg, Germany) received Food and Drug Administration (FDA) approval as a source of fatty acids and calories for infants and children with parenteral nutrition-associated cholestasis. This soy-free fat source is rich in ω-3 fatty acids and α-tocopherol and contains few phytosterols. In comparison to conventional soybean oil ILE, this emulsion appears to be less hepatotoxic. The purpose of this paper is to guide the practitioner on the use of this alternative fat source in clinical practice and augment the material contained in the current package insert. This paper addresses various topics including the identification of which patients would benefit from fish oil ILE, dosing, administration, monitoring, potential adverse effects, and management strategies for fish oil ILE.

• Authors: Kathleen M Gura, Kara L Calkins, Mark Puder
• Journal: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition (Nutr Clin Pract) Vol. 35 Issue 1 Pg. 108-118 (Feb 2020) ISSN: 1941-2452 [Electronic] United States
• PMID: 31549454 (Publication Type: Journal Article)
• Copyright: © 2019 American Society for Parenteral and Enteral Nutrition.

Chemical References

• Fat Emulsions, Intravenous
• Fatty Acids, Omega-3
• Fish Oils

Topics

• Adolescent
• Child
• Child, Preschool
• Cholestasis (etiology, therapy)
• Fat Emulsions, Intravenous (administration & dosage)
• Fatty Acids, Omega-3 (administration & dosage)
• Fish Oils (administration & dosage)
• Humans
• Infant
• Intestinal Diseases (therapy)
• Intestines (pathology)
• Parenteral Nutrition (adverse effects)
• Product Labeling
• Short Bowel Syndrome (therapy)