Lipids in Parenteral Nutrition: Introduction.

Abstract

Thank you for reading this supplement, Lipids in Parenteral Nutrition, which is based upon the international summit “Lipids in Parenteral Nutrition” held on November 2–4, 2018 (Miami, FL, USA). A total of 18 international nutrition and metabolism experts participated in the summit, presenting and discussing topics concerning lipid emulsions in parenteral nutrition.1 The purpose of the summit was to bridge the gap between formal guideline recommendations from several nutrition societies and the practical use of lipid emulsions as part of parenteral nutrition in everyday clinical practice. The summit format allowed for the rapid elucidation of practical and clinical issues, with a range of international multidisciplinary experts presenting on a variety of topics, followed by the formulation of related statements that were voted on anonymously using a Likert-type scale. The statements were based on clinical and scientific evidence, and on the practical clinical experience of the experts when evidence was lacking. Thus, the consensus statements complement formal recommendations, and represent the opinion of the experts, not those of a national or international nutrition society or formal guideline committee. The topics covered by the summit encompassed the general role of lipids in parenteral nutrition, and with a particular focus on their clinical use in different patient populations, including adult and pediatric age groups, and various settings (hospitals and home parenteral nutrition). Although all lipid emulsions were discussed, the topic of lipid emulsions containing fish oil was of special interest because of recent popularity of research in this area and its expanded availability in many countries. Other non-clinical presentations at the summit concerned a review of the biological science of lipid emulsions, the practical handling of lipid emulsions in parenteral nutrition, and the pharmacoeconomics of ω-3 fatty-acid containing lipid emulsions. The summary of proceedings and expert consensus statements from the summit forms the first article in this supplement.1 Thereafter, other reviews have been included based on presentations at the summit, including additional information from the literature. These are: lipids in parenteral nutrition: biological aspects,2 lipid use in hospitalized adults requiring parenteral nutrition,3 the use of lipids in adult patients requiring parenteral nutrition in the home setting,4 use of lipids in neonates requiring parenteral nutrition,5 lipid emulsion use in pediatric patients requiring long-term parenteral nutrition,6 pharmacoeconomics of parenteral nutrition with ω-3 fatty acids in hospitalized adults,7 and the use of intravenous lipid emulsions with parenteral nutrition: practical handling aspects.8 It is hoped that reviewing these areas and formulating these recommendations will help to guide international practice regarding the use of lipid emulsions in parenteral nutrition. Although these recommendations complement rather than take the place of formal nutrition guidelines, we trust that this information may help clinicians and other healthcare professionals to improve the safety and effectiveness of parenteral nutrition. Finally, we would like to thank Fresenius Kabi Deutschland GmbH (Bad Homburg, Germany) for their generosity in funding the international summit, Lipids in Parenteral Nutrition.