Lipid Emulsions in Parenteral Nutrition: One Size Fits All (Patients)?

  • Alessandro Laviano University of Rome
  • Filippo Rossi Fanelli Sapienza University
Keywords: lipid emulsions, metabolism, parenteral nutrition, immune response, inflammation

Abstract

Dietary lipids significantly contribute to preserve the efficiency of human metabolism and restore it during disease. Therefore, in the absence of absolute contraindications, it would not appear reasonable to exclude lipid emulsions when prescribing parenteral nutrition (PN). The metabolic role of lipids has been elucidated, and is far more complex than a mere energy-dense energysource. Indeed, it is now clear that fatty acids impact differently on the inflammatory and immune responses, either promoting or blunting them. Omega-6 fatty acids are the substrate for the production of potent mediators of inflammation, whereas omega-3 fatty acids promote the synthesis of less active factors. Omega-9 fatty acids exert a more neutral impact on immune and inflammatory responses. These specific metabolic activities should therefore be considered when prescribing lipid emulsions in PN. Ideally, the metabolic profile of patients should guide the prescription of lipid emulsions in order to promote the inflammatory response or blunt it according to the clinical needs. This new approach would wholly exploit the metabolic activities of lipid emulsions by providing patients not only with an energy-dense source, but also by priming and/or modulating the immune and inflammatory responses in order to favor healing.

Author Biographies

Alessandro Laviano, University of Rome
Associate Professor of Internal Medicine Department of Clinical Medicine Sapienza University of Rome
Filippo Rossi Fanelli, Sapienza University
Department of Clinical Medicine Sapienza University Rome Italy
How to Cite
Laviano, A., & Fanelli, F. (1). Lipid Emulsions in Parenteral Nutrition: One Size Fits All (Patients)?. South African Journal of Clinical Nutrition, 23(2), S8-S10. Retrieved from http://sajcn.co.za/index.php/SAJCN/article/view/414
Section
Invited Communications