Comparison between two fat emulsions: Intralipid ® 30% vs Intralipid ® 10% in critically ill patients

Fat emulsions, Intralipid® 30% and Intralipid® 10% were compared in terms of the resultingplasma levels of different lipid components and clinical tolerance in critically-ill patients with multi-injuries. Sixteen critically-ill patients with severe systemic inflammatory response were randomly assigned to two groups, each one comprised of eight patients. Each group was administered the same quantity of fat/Kg/day either Intralipid® 30% or Intralipid® 10%. The infusion lasted 12 h daily for 6 days. During the infusion of the fat emulsion, a lower median plasma concentration of triglycerides, phospolipids and free cholesterol was observed in patients who received Intralipid® 30% compared with those who received Intralipid® 10%. The above observations were sustained 4 h after the termination of the infusion. Free fatty acids had a higher mean plasma concentration in the group of patients who received Intralipid® 30%. There were no differences between the two groups as far as the median plasma concentration of cholesterol and lipoproteins (LDL, HDL, VLDL) are concerned. On the contrary, there was an increase in LpX in the Intralipid® 10% group. From the above findings, we draw the conclusion that Intralipid® 30% revealed better profiles of different lipid components than Intralipid®10% in critically-ill patients. The new emulsion of higher concentration in triglyceride was proved clinically safe and its use is suggested for critically-ill patients who require total parenteral nutrition.