Intravenous Nutrition in Hospitalized Patients: Comparison of Two Oils
Parenteral Nutrition in Hospitalized Patients: Comparison of Two Commercially Available Lipid Emulsions
Intravenous nutrition is an important therapy for the recovery of many patients. It is
indicated when the patients cannot take food by mouth or use their intestines for feeding.
It is important to indicate it in the appropriate setting because it's not free of
complications and is a costly treatment. Some of the complications are: elevated blood sugar
or lipids, elevated liver function tests, infection of the catheter or device used to
administer intravenous nutrition. Intravenous nutrition is composed by proteins, lipids,
carbohydrates (sugar in the form of glucose) and vitamins. Until recently, Intralipid, a
soybean oil-based lipid emulsion was the only lipid available in Canada for this kind of
nutrition. Since 2010, a new lipid emulsion (ClinOleic) based on olive-oil has been approved
by Health Canada for use in intravenous nutrition. There is an increasing need for hospitals
to evaluate the quality of intravenous nutrition administered to hospitalized patients in
terms of: assessing indications, prescription, complications, clinical results and costs.
The objective of this study is to determine if intravenous nutrition prescribed in
hospitalized patients is indicated following existing guidelines in terms of timing of
nutrition support, prescription, monitoring and whether it is associated with complications.
In addition, length of stay and mortality will be assessed. Also, we will evaluate
nutritional, infectious and inflammatory parameters in patients receiving soybean oil-based
lipid emulsion (Intralipid) compared to those of patients receiving olive oil-based lipid
Until recently, Intralipid, a soybean oil-based lipid emulsion, has been the only available
lipid for intravenous use in Canada. In 2010, ClinOleic, a new, predominantly olive oil
based emulsion, has been approved by Health Canada as an alternative lipid.
There is an increasing need for hospitals to do quality-assurance studies for in-patient
parenteral nutrition (PN) to assess indications, PN prescription, complications, clinical
outcomes and costs. The only in-patient population that is well studied is the intensive
care unit (ICU) population. Several meta-analyses showed that PN was associated with higher
infection rate, longer length of stay and higher mortality when compared with enteral
nutrition. Results from these and other studies were the basis for the Canadian ICU
The aim of this study is to determine if PN prescribed in in-patients is indicated,
appropriately following existing guidelines in terms of timing of nutrition support,
prescription and monitoring and, whether it is associated with complications. In addition,
clinical outcomes such as length of stay and mortality will be assessed. Also, we will
evaluate metabolic, nutritional, infectious and inflammatory parameters in patients
receiving soybean oil-based lipid emulsion compared to those of patients receiving olive
oil-based lipid emulsion.
Obstruction, Cancer, Ileus, Malnutrition, Surgery
Parenteral nutrition, lipid emulsion, Intralipid, ClinOleic, Inflammation, Infection, Bloodstream Infection, length of stay, mortality
University Health Network, Toronto