脂肪乳的临床应用.ppt

Lipids were originally provided as a source of EFAs and calories. However, since that time, we have come to know that fatty acids are biologically active molecules that play key roles in gene activation, cell signaling, the inflammatory response, and as critical components of membrane phospholipids. Fatty acids are also capable of undergoing lipid peroxidation, producing hydroperoxides capable of oxidizing DNA, protein, and other fatty acids (eg, those composing low-density lipoprotein [LDL] particles, creating LDL that is more atherogenic). * * * * Maintenance of normal hepatobiliary function is an important consideration for patients receiving parenteral lipid therapy. Maintenance of normal hepatobiliary function is an important consideration for patients receiving parenteral lipid therapy. The high phytosterol content of soybean oil emulsions is one of several factors that have been implicated in the development of PNALD (Elleg?rd et al. Clin Nutr. 2005;24:415-420; Llop et al. Nutrition. 2008;24:1145-1152). Other factors that have been correlated with the development of PNALD include excessive calorie intake; nutritional deficiencies (eg, of taurine, carnitine, or choline); a diagnosis of short bowel syndrome (specifically, a bowel remnant length <50 cm in length); duration of PN (ie, longer duration = greater risk of PNALD); an underlying risk for liver disease (eg, concomitant infectious hepatitis or hepatotoxic medications); and intake of ≥1 g/kg/day of an w-6-rich lipid emulsion (Cavicchi et al. Ann Intern Med. 2000;132:525-532; Kumpf. Nutr Clin Pract. 2006;21:279-290). The reduced phytosterol content of CLINOLEIC may therefore predispose to a reduced risk of hepatobiliary dysfunction. The high phytosterol content of soybean oil emulsions is one of several factors that have been implicated in the development of PNALD (Elleg?rd et al. Clin Nutr. 2005;24:415-420; Llop et al. Nutrition. 2008;24:1145-1152). Other factors that have been correlated with th