Position of the American Society for Parenteral & Enteral Nutrition (ASPEN) adopted by the Academy
The ASPEN Position Paper: Clinical Role for Alternative Intravenous Fat Emulsions was developed by ASPEN’s working group on Parenteral Fat Emulsions. It outlines the history, uses and complications of intravenous fat emulsions (IVFEs) currently available in the United States, which are made from soybean oil (SO). The working group completed a thorough review of the literature on alternative IVFEs and developed a position statement based on this research. This paper outlines their findings regarding these IVFEs, which include medium chain triglycerides, olive oils and fish oils. These have been extensively used in Europe and appear to have an equivalent safety profile to SO. The authors point out potential advantages of using alternative IVFEs for those patients that do not tolerate SO based emulsions well. They point out that certain patients may have improved clinical outcomes when using alternative IVFEs due to less systemic inflammation and less immune suppression. Additional research is still needed to determine which of these alternative IVFEs is best to use with specific patient populations. Of note is that these alternative IVFEs are not yet approved by the FDA for use in the United States.
The position paper was published in Nutrition in Clinical Practice, April 2012, volume 27, Number 2, pages 150-192.