Indications
20% Fat Emulsion is an intravenous (IV) lipid emulsion used in hospital as part of parenteral nutrition, to supply energy (calories) and essential fatty acids to patients who cannot eat or absorb enough food through the gut. It is usually given together with amino acids, glucose, electrolytes, vitamins and trace elements.
How It Works
The emulsion contains tiny droplets of purified oil (such as soybean oil, sometimes mixed with olive oil, fish oil or medium-chain triglycerides), stabilised with egg phospholipids and with glycerol added. Once in the blood, the fat droplets are broken down and used by the body for energy, much like fats from food. It also supplies essential fatty acids, which the body cannot make and needs for healthy cells, skin and wound healing.
Dosage and Administration
It is given by a doctor or nurse in hospital as a slow infusion into a vein, either on its own or mixed in a nutrition bag. The amount and infusion rate depend on body weight, age, the patient’s condition and blood fat (triglyceride) levels, and are as prescribed. The infusion is started slowly and the patient is watched for reactions.
Interactions
- Heparin given with the infusion can temporarily affect fat clearance from the blood.
- Soybean oil contains vitamin K, which may reduce the effect of Warfarin and similar medicines; clotting tests may need closer checks.
- Lipid in the blood may interfere with some laboratory tests; samples are usually taken after the fat has cleared.
- Do not add other medicines to the emulsion unless confirmed compatible by the pharmacy.
Contraindications
- Allergy to egg, soybean, peanut or fish protein, or to any ingredient.
- Severe hyperlipidaemia (very high blood fats) or severe disorders of fat metabolism.
- Severe liver failure, severe blood clotting disorders, or unstable conditions such as acute shock.
Side Effects
Possible side effects include a slight rise in temperature, chills, flushing, nausea, vomiting, headache, back or chest pain and a feeling of warmth during the infusion. Raised blood fats and liver test changes can occur. Rarely, fat overload syndrome may develop (fever, enlarged liver and spleen, low platelets, bleeding problems, breathing difficulty), especially if infused too quickly. IV line infection is also possible.
Tell the nurse at once if the patient has breathlessness, chest pain, swelling of the face or throat, a rash, high fever or chills, unusual bleeding or bruising, yellowing of the skin, or pain, swelling or redness at the drip site.
Pregnancy and Lactation
Lipid emulsions may be used in pregnancy and during breastfeeding when nutrition through a vein is needed, under close medical supervision.
Precautions and Warnings
- Blood triglycerides, liver function, blood sugar and platelet counts are monitored.
- Used with extra care in premature babies and newborns, in severe infection, and in kidney or liver disease.
- Strict aseptic technique is used to reduce infection risk.
- Do not use if the emulsion has separated, shows oily droplets or the bag is damaged.
Overdose
Infusing too much or too fast can cause fat overload syndrome. The infusion is stopped, and the symptoms usually settle; supportive treatment is given as needed.
Therapeutic Class
Parenteral nutrition; intravenous lipid (fat) emulsion.
Storage
Store below 25°C, do not freeze, as directed on the pack. Discard if it has been frozen. It is stored and prepared by hospital staff.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.