Intralipid (Soybean Oil Emulsion)
Intravenous fat emulsion for parenteral nutrition and essential fatty acid supplementation
Intralipid is an intravenous fat emulsion containing purified soybean oil, used primarily in parenteral nutrition to supply energy and essential fatty acids to patients who cannot receive adequate nutrition orally or enterally. It is also increasingly recognized as a critical emergency treatment for local anesthetic systemic toxicity (LAST). Intralipid is administered exclusively under medical supervision in hospital or clinical settings.
Quick Facts
Key Takeaways
- Intralipid is a soybean oil-based intravenous fat emulsion used to provide essential fatty acids and concentrated energy in parenteral nutrition.
- It must be administered under medical supervision via peripheral or central venous catheter with regular monitoring of serum triglyceride levels.
- Contraindicated in patients with severe hyperlipidemia, severe liver insufficiency, or allergy to soy, egg, or peanut protein.
- Intralipid 20% is recognized as a first-line emergency treatment for local anesthetic systemic toxicity (LAST).
- Common side effects include nausea, elevated body temperature, and transient rises in serum triglycerides; fat overload syndrome is a rare but serious complication.
What Is Intralipid and What Is It Used For?
Intralipid is a sterile, non-pyrogenic fat emulsion designed for intravenous administration. The primary active ingredient is purified soybean oil, which provides long-chain triglycerides including the essential fatty acids linoleic acid (an omega-6 fatty acid) and alpha-linolenic acid (an omega-3 fatty acid). These essential fatty acids cannot be synthesized by the human body and must be obtained from dietary sources or, in the case of patients unable to eat, through intravenous supplementation.
The emulsion is stabilized by egg yolk phospholipids, which serve as an emulsifying agent, and glycerol, which makes the formulation isotonic with blood. The resulting fat particles have a size distribution similar to natural chylomicrons (approximately 0.4 micrometers), allowing them to be cleared from the bloodstream through the same metabolic pathways as dietary fats. This physiological similarity is a key advantage of Intralipid over earlier fat emulsion formulations.
In clinical practice, Intralipid serves several important roles. Its primary indication is as part of total parenteral nutrition (TPN) or supplemental parenteral nutrition for patients who cannot receive sufficient nutrition through the gastrointestinal tract. This includes patients with severe gastrointestinal diseases such as short bowel syndrome, intestinal obstruction, severe pancreatitis, prolonged ileus, or those recovering from major abdominal surgery. It is also essential in neonatal intensive care for premature infants who require intravenous feeding.
Beyond parenteral nutrition, Intralipid has gained significant importance as a lipid rescue therapy. The Association of Anaesthetists of Great Britain and Ireland (AAGBI) and the American Society of Regional Anesthesia (ASRA) recommend Intralipid 20% as an emergency treatment for local anesthetic systemic toxicity (LAST), a potentially fatal complication that can occur during regional anesthesia procedures. The lipid emulsion acts as a "lipid sink," sequestering lipophilic local anesthetic molecules from cardiac and neural tissue, thereby restoring normal cardiac conduction and contractility.
Intralipid is also used in some reproductive medicine protocols. Some fertility specialists administer Intralipid infusions to patients undergoing in vitro fertilization (IVF) who have elevated natural killer (NK) cell activity, although the evidence for this application remains limited and is not universally endorsed by reproductive medicine guidelines. Additionally, Intralipid emulsion serves as the lipid vehicle in the formulation of propofol, a widely used intravenous anesthetic agent.
What Should You Know Before Receiving Intralipid?
Intralipid is a hospital-administered medication that requires careful medical assessment before initiation. Your treating physician will evaluate several factors before prescribing this fat emulsion, including your current nutritional status, underlying medical conditions, lipid metabolism capacity, and any known allergies. Understanding these considerations helps ensure safe and effective treatment.
Contraindications
Intralipid must not be administered to patients with the following conditions:
- Hypersensitivity to soy, egg, or peanut protein: Intralipid contains purified soybean oil and egg yolk phospholipids. Cross-reactivity between soy and peanut allergens is well-documented. Patients with confirmed allergies to any of these substances must not receive Intralipid. Alternative lipid emulsions based on olive oil or fish oil may be considered.
- Severe hyperlipidemia: Patients with pathological hyperlipidemia, including severe hypertriglyceridemia (serum triglycerides above 4.6 mmol/L or 400 mg/dL), should not receive Intralipid until lipid levels are corrected.
- Severe liver insufficiency: Significant hepatic impairment reduces the capacity to metabolize and clear lipid particles from the bloodstream, increasing the risk of fat overload syndrome.
- Severe coagulation disorders: Lipid emulsions can interfere with coagulation testing and, in some cases, may exacerbate bleeding tendencies in patients with pre-existing coagulopathies.
- Acute shock and dehydration: Hemodynamic instability and severe fluid imbalance must be corrected before initiating lipid infusion.
- Acute pulmonary embolism: IV lipid emulsion should be avoided in the setting of acute pulmonary vascular compromise.
Warnings and Precautions
Several clinical scenarios require enhanced monitoring or dose adjustment when using Intralipid. Patients with diabetes mellitus may experience alterations in blood glucose levels during lipid infusion. Those with renal impairment may have reduced lipid clearance capacity and require lower infusion rates. Patients with metabolic acidosis, sepsis, or conditions associated with hyperlipidemia (such as nephrotic syndrome or certain endocrine disorders) require careful monitoring of serum triglyceride levels throughout treatment.
Regular laboratory monitoring is essential during Intralipid therapy. Serum triglyceride levels should be checked before the start of infusion and at regular intervals (typically 5-6 hours after starting). If serum triglycerides exceed 4.6 mmol/L (400 mg/dL) during infusion, the rate should be reduced or the infusion temporarily stopped. Liver function tests, blood glucose, serum electrolytes, and complete blood counts should also be monitored at appropriate intervals determined by the treating physician.
Fat overload syndrome is a rare but potentially fatal complication of excessive or too-rapid lipid infusion. Symptoms include sudden deterioration in the patient's condition with fever, jaundice, hepatomegaly, splenomegaly, anemia, thrombocytopenia, coagulation disorders, hyperlipidemia, and multi-organ failure. If any symptoms of fat overload are observed, the Intralipid infusion must be stopped immediately. Fat overload syndrome is usually reversible upon discontinuation of the lipid emulsion.
Pregnancy and Breastfeeding
Intralipid may be used during pregnancy when parenteral nutrition is medically indicated and the benefit to the mother outweighs any potential risk. In clinical practice, pregnant women who cannot maintain adequate oral or enteral nutrition may require parenteral nutrition including lipid emulsion to support both maternal and fetal nutritional needs. Close monitoring of lipid levels and liver function is particularly important during pregnancy.
During breastfeeding, Intralipid can be administered when clinically necessary. The fatty acids provided by the emulsion are physiological components of human milk, and intravenous lipid supplementation is not expected to adversely affect the composition of breast milk in a clinically significant way. However, as with all medications during lactation, the decision should be made in consultation with the treating physician who can weigh the benefits and risks in each individual case.
In reproductive medicine, Intralipid has been used off-label as an immunomodulatory therapy in some IVF protocols. While some observational studies have suggested potential benefits for implantation rates in women with elevated NK cell activity, major reproductive medicine societies have not endorsed this indication due to insufficient high-quality evidence. Patients considering Intralipid as part of fertility treatment should discuss the evidence base thoroughly with their fertility specialist.
How Does Intralipid Interact with Other Drugs?
Drug interactions involving intravenous lipid emulsions are an important consideration in hospital pharmacy and clinical care. Because Intralipid is typically administered to critically ill patients who are receiving multiple medications simultaneously, understanding potential interactions is essential for safe prescribing and monitoring.
The most clinically significant interactions involve the capacity of lipid emulsions to alter the distribution and activity of lipophilic drugs. When fat-soluble medications are co-administered with Intralipid, the lipid particles can act as a reservoir, potentially altering the free drug concentration in plasma. This pharmacokinetic interaction is therapeutically exploited in lipid rescue therapy for local anesthetic toxicity but can be problematic with other medications.
Major Interactions
| Drug | Type of Interaction | Clinical Significance | Recommendation |
|---|---|---|---|
| Heparin | Lipid emulsions can release lipoprotein lipase, which may transiently increase heparin effect and alter coagulation parameters | High | Monitor aPTT closely; may need heparin dose adjustment |
| Cyclosporine | Lipid emulsions can bind cyclosporine, potentially reducing free drug concentration and therapeutic efficacy | High | Monitor cyclosporine blood levels; adjust dose as needed |
| Insulin | Lipid infusion can impair insulin sensitivity and increase blood glucose | Moderate | Monitor blood glucose frequently; adjust insulin dosing accordingly |
| Propofol | Propofol is formulated in a lipid emulsion; concurrent Intralipid adds to total lipid load | Moderate | Account for lipid content of propofol in total daily lipid intake calculations |
Minor Interactions and Laboratory Interference
Intralipid can cause significant interference with clinical laboratory tests. The lipemia (milky appearance) of blood samples drawn during or shortly after lipid infusion can affect many spectrophotometric assays. Specifically affected tests include serum bilirubin, lactate dehydrogenase (LDH), oxygen saturation (pulse oximetry in severe lipemia), and some immunoassays. Blood samples for laboratory tests should ideally be drawn before starting the infusion or at least 5-6 hours after the infusion is completed to allow adequate lipid clearance.
Additionally, certain electrolyte additives are incompatible with lipid emulsions. Divalent cations such as calcium and magnesium in high concentrations can destabilize the emulsion by neutralizing the negative surface charge of the lipid particles. This can lead to phase separation or "cracking" of the emulsion, which poses a risk of fat embolism if the destabilized product is infused. For this reason, strict compatibility guidelines must be followed when adding medications or electrolytes to Intralipid or when co-infusing through the same intravenous line.
Never add medications directly to Intralipid without consulting pharmacy compatibility guidelines. Many drugs are physically incompatible with lipid emulsions and can cause visible phase separation, precipitation, or invisible changes that compromise patient safety. When in doubt, administer through a separate IV line.
What Is the Correct Dosage of Intralipid?
Intralipid dosing is individualized based on the patient's clinical condition, nutritional requirements, metabolic capacity, and the specific formulation being used (10%, 20%, or 30%). The prescribing physician, often in collaboration with a clinical nutrition specialist or pharmacist, determines the appropriate dose and infusion rate. General dosing guidelines are provided below, but these should always be adapted to the individual patient.
Adults
Parenteral Nutrition - Intralipid 20%
Standard dose: 1-2 g fat/kg body weight/day (equivalent to 5-10 mL of 20% emulsion per kg/day)
Maximum dose: 3 g fat/kg/day (15 mL of 20% per kg/day)
Initial infusion rate: 0.5-1 mL/min for the first 15-30 minutes
Maintenance rate (20%): Should not exceed 500 mL in 5 hours
Lipids should generally comprise 25-40% of total non-protein calories in parenteral nutrition regimens, as recommended by ESPEN and ASPEN guidelines.
| Patient Group | Daily Dose (g fat/kg) | Maximum Rate | Special Considerations |
|---|---|---|---|
| Adults | 1-2 g/kg/day | 500 mL over 5 hours (20%) | Start slowly; monitor triglycerides |
| Premature neonates | 0.5-1 g/kg/day initially, up to 3 g/kg/day | 0.15 g/kg/hour (20%) | Start at 0.5 g/kg/day; increase by 0.5 g/kg/day |
| Term neonates & infants | 1-2 g/kg/day, up to 3-4 g/kg/day | 0.15 g/kg/hour (20%) | Monitor bilirubin; lipids compete with bilirubin for albumin binding |
| Children (1-10 years) | 1-3 g/kg/day | 0.15 g/kg/hour (20%) | Adjust based on growth requirements and fat tolerance |
| Adolescents | 1-2 g/kg/day | As per adult guidelines | Transition to adult dosing as appropriate |
Children
Pediatric dosing of Intralipid requires particular care and expertise. Neonates, especially premature infants, have immature lipid metabolism and may clear lipid emulsions more slowly than adults. The initial dose should be conservative, typically 0.5-1 g/kg/day, with gradual increases of 0.5 g/kg/day as tolerated. Serum triglyceride levels should be monitored before each dose increase.
An important consideration in neonatal care is the interaction between free fatty acids and unconjugated bilirubin. Both compete for albumin binding sites, and in hyperbilirubinemic neonates, excessive lipid infusion can theoretically displace bilirubin from albumin, increasing the risk of bilirubin encephalopathy (kernicterus). Current guidelines recommend maintaining serum triglycerides below 2.0 mmol/L in jaundiced neonates and considering reduced lipid doses when bilirubin levels are significantly elevated.
For children aged 1-10 years, lipid requirements are relatively higher per kilogram of body weight than in adults due to the energy demands of growth. Doses of 1-3 g/kg/day are commonly used, with the higher end reserved for patients with increased energy requirements such as those recovering from burns, surgery, or severe infections. ESPGHAN (European Society for Paediatric Gastroenterology, Hepatology and Nutrition) provides detailed evidence-based guidelines for pediatric parenteral nutrition.
Elderly
In elderly patients, lipid clearance may be reduced due to age-related decreases in hepatic function and lipoprotein lipase activity. Initial dosing should generally be at the lower end of the recommended range, with careful monitoring of serum triglycerides and liver function. Co-morbidities common in the elderly, such as diabetes, atherosclerotic disease, and hepatic steatosis, may also influence the choice and dosing of lipid emulsion. The infusion rate should be increased more gradually in elderly patients to allow adequate metabolic adaptation.
Lipid Rescue Therapy (LAST Protocol)
The following protocol is for healthcare professionals managing LAST. This is an emergency situation requiring immediate intervention alongside advanced cardiac life support (ACLS).
LAST Lipid Rescue Protocol - Intralipid 20%
Initial bolus: 1.5 mL/kg lean body mass IV over 1 minute
Continuous infusion: 0.25 mL/kg/min
Repeat bolus: If cardiovascular collapse persists, give up to 2 additional boluses at 5-minute intervals
Increase infusion: Double to 0.5 mL/kg/min if blood pressure remains low
Maximum total dose: Approximately 12 mL/kg over the first 30 minutes
Continue infusion for at least 15 minutes after achieving circulatory stability. Propofol should NOT be used as a substitute for lipid emulsion in LAST treatment.
Missed Dose
Because Intralipid is administered in a controlled clinical setting under direct medical supervision, missed doses are managed by the healthcare team. If a scheduled infusion is delayed or interrupted, the physician will assess whether the remaining dose should be administered or whether the total daily volume should be adjusted. Patients should not attempt to "make up" for a missed dose by increasing the infusion rate, as this can lead to lipid overload and metabolic complications.
Overdose
Overdose with Intralipid, whether from excessive rate or total volume, can lead to fat overload syndrome. This is characterized by hyperlipidemia, fever, hepatomegaly, splenomegaly, coagulation disorders, anemia, leukopenia, thrombocytopenia, and altered liver function. In severe cases, multi-organ failure may develop. Treatment involves immediately stopping the infusion, supportive care, and close monitoring. Fat overload syndrome is usually reversible when the lipid infusion is discontinued promptly. There is no specific antidote; management is symptomatic and supportive.
What Are the Side Effects of Intralipid?
Like all medications, Intralipid can cause side effects, although not everyone experiences them. The frequency and severity of side effects are often related to the infusion rate and total dose administered. Most side effects are mild and transient, resolving after the infusion is completed or the rate is reduced. However, healthcare providers should be vigilant for signs of serious adverse reactions, particularly fat overload syndrome and allergic reactions.
The following side effects are categorized by frequency according to international pharmacovigilance conventions. It is important to note that many of the reported side effects occur in the context of critically ill patients receiving multiple medications simultaneously, making it sometimes difficult to attribute specific adverse events solely to the lipid emulsion.
Common
May affect up to 1 in 10 patients
- Nausea
- Transient elevation in body temperature
- Elevated serum triglyceride levels
- Mild elevation of liver enzymes (ALT, AST, GGT)
- Feeling of warmth during infusion
- Headache
Uncommon
May affect up to 1 in 100 patients
- Vomiting
- Abdominal pain
- Thrombophlebitis at the infusion site
- Chills or shivering during infusion
- Tachycardia (increased heart rate)
- Dyspnea (shortness of breath)
- Back pain or chest tightness
Rare
May affect up to 1 in 1,000 patients
- Allergic reactions (including anaphylaxis in patients allergic to soy, egg, or peanut)
- Fat overload syndrome (hyperlipidemia, fever, hepatosplenomegaly, coagulopathy, multi-organ involvement)
- Hepatic steatosis with prolonged use
- Parenteral nutrition-associated liver disease (PNALD) with long-term use
- Hypotension during rapid infusion
- Hemolytic anemia (very rare)
- Priapism (isolated case reports)
Patients receiving long-term parenteral nutrition with Intralipid require special attention to hepatic complications. Parenteral nutrition-associated liver disease (PNALD), also known as intestinal failure-associated liver disease (IFALD), is a significant concern in patients dependent on parenteral nutrition for extended periods. Risk factors include excessive lipid doses (greater than 1 g/kg/day in adults on long-term PN), lack of enteral feeding, sepsis, and prematurity. Strategies to reduce this risk include limiting soybean oil-based lipid intake, cycling parenteral nutrition (infusing over less than 24 hours), and, where possible, using alternative lipid emulsions containing fish oil (omega-3 fatty acids), which appear to have hepatoprotective properties.
Infusion-site reactions, including thrombophlebitis, are more common with peripheral venous administration and with the 10% formulation (which has a higher phospholipid-to-triglyceride ratio). Using central venous access, the 20% formulation, and appropriate infusion rates can minimize these complications. If signs of phlebitis develop (redness, pain, swelling along the vein), the infusion site should be changed.
Report any unusual symptoms during or after Intralipid infusion to your nurse or physician immediately. Seek urgent medical attention if you experience difficulty breathing, skin rash or hives, severe abdominal pain, persistent fever, unusual bleeding or bruising, or a sudden feeling of being unwell. These may indicate a serious adverse reaction that requires prompt medical intervention.
How Should You Store Intralipid?
Proper storage of Intralipid is critical to maintaining the stability and safety of the emulsion. As a hospital-use product, storage is typically managed by the pharmacy department, but understanding storage requirements is important for all healthcare professionals involved in parenteral nutrition preparation and administration.
Unopened containers of Intralipid should be stored at room temperature, ideally below 25°C (77°F). The product must not be frozen, as freezing destroys the emulsion structure and causes irreversible phase separation, making the product unsafe for intravenous use. If accidental freezing occurs, the product must be discarded even if it appears to return to a uniform consistency after thawing.
Once opened or transferred to an infusion bag, Intralipid should be used immediately. From a microbiological standpoint, the lipid emulsion provides an excellent growth medium for bacteria and fungi, making aseptic handling essential. If not used immediately after opening, the product should be used within 24 hours and stored at 2-8°C (36-46°F), although local hospital policies may specify different timeframes based on their validated protocols.
When Intralipid is admixed with amino acids, glucose, electrolytes, and other components to create an all-in-one (AIO) parenteral nutrition bag, the stability of the admixture depends on the specific composition, concentrations, pH, and storage conditions. Compounded parenteral nutrition bags are typically assigned an expiry of 24-48 hours depending on whether they are refrigerated or stored at room temperature, following institutional pharmacy protocols. Light protection during prolonged infusion is recommended, particularly for neonatal patients, as light-induced lipid peroxidation can generate harmful free radicals.
Before administration, always visually inspect Intralipid. A normal emulsion appears as a homogeneous, milky-white liquid. Do not use if you observe oil droplets floating on the surface, visible phase separation, discoloration, or particulate matter. These signs indicate emulsion destabilization, and the product must be discarded. The container should also be checked for damage, cracks, or leaks before use.
What Does Intralipid Contain?
Understanding the full composition of Intralipid is important for clinical decision-making, particularly regarding allergy assessment, caloric calculations, and compatibility with other parenteral nutrition components.
Active Ingredient
The active ingredient in Intralipid is purified soybean oil, which provides long-chain triglycerides (LCT). The fatty acid profile of soybean oil is predominantly polyunsaturated, with the following approximate composition: linoleic acid (omega-6) approximately 44-62%, oleic acid approximately 19-30%, palmitic acid approximately 7-14%, alpha-linolenic acid (omega-3) approximately 4-11%, and stearic acid approximately 1.4-5.5%. Linoleic acid and alpha-linolenic acid are essential fatty acids, meaning they cannot be synthesized by the body and must be supplied exogenously.
Excipients (Inactive Ingredients)
- Egg yolk phospholipids (1.2% w/v): These serve as the emulsifying agent, stabilizing the oil-in-water emulsion by forming a phospholipid monolayer around each oil droplet. The phospholipids are derived from purified egg yolk and are the reason Intralipid is contraindicated in patients with egg allergy.
- Glycerol (2.25% w/v): Added to make the emulsion isotonic with blood (approximately 300 mOsm/L), allowing peripheral venous administration without causing hemolysis or venous irritation.
- Water for injections: The aqueous phase of the emulsion, constituting the majority of the volume.
- Sodium hydroxide: Used for pH adjustment to approximately 8 (range 6-8.9).
Energy Content by Formulation
| Parameter | Intralipid 10% | Intralipid 20% | Intralipid 30% |
|---|---|---|---|
| Soybean oil | 100 mg/mL (10 g/100 mL) | 200 mg/mL (20 g/100 mL) | 300 mg/mL (30 g/100 mL) |
| Egg phospholipids | 12 mg/mL | 12 mg/mL | 12 mg/mL |
| Glycerol | 22.5 mg/mL | 22.5 mg/mL | 16.7 mg/mL |
| Energy (kcal/mL) | 1.1 kcal/mL | 2.0 kcal/mL | 3.0 kcal/mL |
| Osmolality | ~300 mOsm/kg | ~350 mOsm/kg | ~310 mOsm/kg |
| Phospholipid:TG ratio | 0.12 (higher - less ideal) | 0.06 (optimal) | 0.04 (lowest) |
The 20% formulation is most commonly used for direct infusion because it has the optimal balance between energy density and phospholipid-to-triglyceride ratio. Excess phospholipids (as seen in the 10% formulation) can accumulate in the bloodstream and form abnormal lipoprotein particles called liposome X, which may impair lipid clearance and potentially contribute to hyperlipidemia. The 30% formulation is primarily intended for use in the compounding of all-in-one parenteral nutrition admixtures rather than direct infusion.
Frequently Asked Questions About Intralipid
Intralipid is an intravenous fat emulsion used primarily as a source of energy and essential fatty acids in parenteral nutrition for patients who cannot eat or absorb food normally. It is also used as lipid rescue therapy for local anesthetic systemic toxicity (LAST), in certain IVF protocols as an immunomodulatory agent, and as a vehicle for fat-soluble medications like propofol. It provides both concentrated calories and the essential fatty acids linoleic acid and alpha-linolenic acid.
Intralipid is administered by intravenous infusion, either through a peripheral or central venous catheter. It must be given slowly, typically starting at a rate of 0.5-1 mL/min for the first 15-30 minutes to assess tolerance. The infusion rate is then gradually increased based on the patient's response. The 20% emulsion should not exceed 500 mL in 5 hours for adults. It is always administered under medical supervision in a hospital or clinical setting.
Yes. Intralipid contains purified soybean oil and egg yolk phospholipids. Patients with known hypersensitivity to soy, egg, or peanut protein should not receive Intralipid, as allergic reactions can range from mild skin reactions to severe anaphylaxis. Cross-reactivity between soy and peanut allergens is recognized. Healthcare providers should be prepared to manage allergic reactions during administration. Alternative lipid emulsions based on different oil sources may be available for patients with these allergies.
Lipid rescue therapy involves the emergency intravenous administration of Intralipid 20% to treat local anesthetic systemic toxicity (LAST), a potentially fatal complication of local anesthetic overdose. A bolus of 1.5 mL/kg is given over 1 minute, followed by a continuous infusion of 0.25 mL/kg/min. The lipid emulsion acts as a "lipid sink" that sequesters lipophilic local anesthetic molecules from cardiac tissue, helping restore cardiac function. This protocol is recommended by major anesthesiology societies worldwide.
During Intralipid infusion, serum triglyceride levels must be monitored regularly - at least before infusion and 5-6 hours after starting. Liver function tests, blood glucose, electrolytes, and blood counts should also be checked at regular intervals. The infusion should be stopped or slowed if serum triglycerides exceed 4.6 mmol/L (400 mg/dL). Signs of fat overload syndrome (fever, hepatosplenomegaly, coagulopathy) should be monitored throughout treatment.
The percentages refer to the concentration of soybean oil: 10% contains 100 mg/mL, 20% contains 200 mg/mL, and 30% contains 300 mg/mL. The 20% formulation is most commonly used because it has the optimal phospholipid-to-triglyceride ratio, making it more physiologically similar to natural chylomicrons. The 10% version has a relatively higher phospholipid content which can lead to abnormal lipoprotein accumulation. The 30% is primarily used for compounding all-in-one parenteral nutrition bags rather than direct infusion.
References
- ESPEN Guidelines on Parenteral Nutrition: Lipid emulsions. Calder PC, et al. Clinical Nutrition. 2024;43(5):1185-1206. European Society for Clinical Nutrition and Metabolism.
- ASPEN Position Paper: Intravenous Fat Emulsions. Mirtallo JM, et al. Journal of Parenteral and Enteral Nutrition. 2020;44(Suppl 1):S7-S20. American Society for Parenteral and Enteral Nutrition.
- Neal JM, et al. The Third American Society of Regional Anesthesia and Pain Medicine Practice Advisory on Local Anesthetic Systemic Toxicity. Regional Anesthesia and Pain Medicine. 2018;43(2):113-123.
- Weinberg GL. Lipid Emulsion Infusion: Resuscitation for Local Anesthetic and Other Drug Overdose. Anesthesiology. 2012;117(1):180-187.
- ESPGHAN/ESPEN/ESPR/CSPEN Guidelines on Pediatric Parenteral Nutrition: Lipids. Lapillonne A, et al. Clinical Nutrition. 2018;37(6):2324-2336.
- WHO Model List of Essential Medicines, 23rd List. World Health Organization. 2023. Parenteral nutrition solutions including lipid emulsions.
- European Medicines Agency (EMA). Summary of Product Characteristics: Intralipid 20%. Fresenius Kabi. Last updated 2024.
- Calder PC, et al. Lipid emulsions in parenteral nutrition of intensive care patients: current thinking and future directions. Intensive Care Medicine. 2010;36(5):735-749.
- Fell GL, et al. Intravenous Lipid Emulsions in Parenteral Nutrition. Advances in Nutrition. 2015;6(5):600-610.
- Association of Anaesthetists of Great Britain and Ireland (AAGBI). Management of Severe Local Anaesthetic Toxicity. Safety Guideline. 2023.
Medical Editorial Team
This article has been written and reviewed by qualified medical professionals with expertise in clinical pharmacology, nutrition medicine, and critical care.
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iMedic Medical Editorial Team - Specialists in Clinical Pharmacology and Nutrition Medicine
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iMedic Medical Review Board - Independent review following ESPEN, ASPEN, and WHO guidelines
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