intravenous fat emulsion, a preparation of 10% fat administered into a vein to help maintain the weight of an adult patient or the weight and growth of a younger patient. Such fat emulsions are prepared from refined soybean oil and egg-yolk phospholipids and may contain such major fatty acids as linoleic, oleic, palmitic, and linolenic acids. The IV fat emulsion is isotonic and may be administered into a peripheral vein, but it is not mixed with other solutions used in parenteral alimentation. IV fat emulsions are often administered when hyperalimentation is not sufficient to maintain adequate treatment of a patient or when the patient needs calories but cannot tolerate the high percentage of dextrose contained in hyperalimentation solutions. Such emulsions may also be administered to patients who need more essential fatty acids than are contained in hyperalimentation solutions or who need general nutritional improvement, especially postoperative patients. IV emulsions are not administered to patients suffering from disturbances of normal fat metabolism (such as hyperlipemia), severe hepatic diseases, blood coagulation defects caused by decreased blood-platelet counts, pulmonary diseases, lipoid nephrosis, hepatocellular damage, or bone marrow dyscrasia or to those being treated with anabolic inhibitory drugs. If possible, the IV fat emulsion is usually administered during the day so that the patient may follow a normal eating pattern with rest during the night and lower nocturnal urinary flow. Once the primary IV line has been established, IV fat emulsions are usually administered with the aid of an electronic control device to maintain an even flow rate and prevent fatty-acid overload. The patient’s fluid intake and output are regularly measured during the delivery of such an emulsion, and daily blood studies are conducted to determine the level of free-floating triglycerides. Hepatic function tests are performed if the patient receives consecutive IV fat emulsion infusions over a long period. Immediate adverse reactions or those that may occur up to 2½ hours after the onset of the infusion may include temperature rise, flushing, sweating, pressure sensations over the eyes, nausea, vomiting, headache, chest and back pain, dyspnea, and cyanosis. Delayed adverse reactions or those that occur within 10 days of the onset of such infusions may include hepatomegaly, splenomegaly, thrombocytopenia, focal seizures, hyperlipemia, hepatic damage, jaundice, hemorrhagic diathesis, and gastroduodenal ulcer.
