Administration of Fat Emulsions

Abstract

In our bone marrow transplant unit, a 20-bed facility, we treat patients with leukemia and aplastic anemia. In preparation for a bone marrow transplant all patients receive 1,000 rads of total body irradiation and/or high-dose chemotherapy. This treatment destroys the patient's bone marrow function to prepare for the acceptance of a bone marrow transplant from a sibling or from one of the parents. Both the chemotherapy and the irradiation result in loss of appetite, nausea, vomiting, and severe mucositis leading to reduced oral intake. In addition, the body's nutritional requirements are increased by such occurrences as fever, infection, and graft-versus-host disease. Thus, at the same time oral intake is diminished, nutritional requirements are increased, leading to the possibility of a severely compromised nutritional state. One of the prominent nutritional deficiencies has been essential fatty acid deficiency (EFAD). This occurs both because of reduced oral intake of fats and because stored body fat is being used to meet energy requirements(1). The occurrence of EFAD can intensify the potential adverse effects of total body irradiation and chemotherapy. The common signs of EFAD