Parenteral nutrition: current status and concepts

6 Final Report on the Safety Assessment of Safflower Oil

Safflower Oil is a polyunsaturated edible seed oil consisting primarily of triglycerides of linoleic acid. The oil is used in cosmetics as an emollient in topical lotions and creams at concentrations normally between 0.1 and 5 percent. The pure oil produced slight to moderate comedogenicity. However, products containing up to 5 percent Safflower Oil were not comedogenic in rabbits. Results of animal tests indicated that Safflower Oil was not an eye or skin irritant or contact sensitizer. The oil increased the incidence of 12-dimethylbenz(a)anthracene in rats.

Safflower Oil has been used to treat human essential fatty acid deficiencies via oral and topical administration and is often applied to irritated and abraded skin. Products containing up to 5 percent Safflower Oil were negative for human skin irritation, sensitization, or photosensitization.

From the information presented in this report, it is concluded that Safflower Oil is safe as a cosmetic ingredient in the present practices of use.

Isocaloric feeding and medium chain triglycerides fail to improve liver function tests in a patient with Crohn's disease and a high output stoma

A patient with Crohn's disease complicated by multiple fistulae to the skin and bladder and a high-output stoma following previous multiple short bowel resections developed liver dysfunction during total parenteral nutrition. Isocaloric feeding based on calorimetry and changing from a long chain triglyceride emulsion to a mixture of medium and long chain triglyceride emulsion failed to improve liver function. Surgical removal of the affected small bowel resulted in a rapid improvement of the liver function despite continuation of total parenteral nutrition.

Adverse metabolic consequences of nutritional support: micronutrients

The role of total parenteral nutrition in cancer patients is still a matter of controversy. Over the last decade there has been a heightened interest in the interaction of micronutrients with tumor cells. A review of the literature reveals that the question of feeding or suppressing the tumor by supplementing micronutrients remains unanswered. Prospective studies are needed to define the requirements of vitamins and trace elements in the cancer patient.

Comparison of total nutrient admixture stability using two intravenous fat emulsions, Soyacal and Intralipid 20%

The safe clinical use and physical stability of a total nutrient admixture (TNA) system containing a soybean oil emulsion (Intralipid) has been reported. A study was conducted to compare the physical stability of four admixtures which were divided into two groups based upon the ratios (1:1:1 and 2:1:1) of amino acids (8.5%), dextrose (70%), and fat emulsion (20%). The fat component in each group contained either a new soy bean fat emulsion, Soyacal, or Intralipid. The quantities of all electrolytes, trace elements and vitamin additives were the same. All solutions were stored at 4 degrees C for 28 days and then held at ambient temperature for 5 days for a total 33-day study period. Each admixture was serially analyzed on days 0, 1, 2, 3, 5, 7, 14, 21, 28, 29, 30, 31, 32, and 33. Examination of gross visual appearance and determinations of pH were performed. Osmolality was measured by means of freezing point depression (Advanced Digimatic Osmometer, Advanced Instruments, Inc., Needham Heights, MA). A Brookhaven particle analyzer was used to measure lipid particle size and particle size distribution. Electron and light microscopy were used to verify maximum particle size and distribution on days 0, 7, 14, 21, 28, and 29. The type of lipid emulsion used did not affect the pH or osmolality of the admixtures. Admixtures prepared with the 2:1:1 ratio had slightly higher pH (0.07) and lower osmolality (350 mOsm/kg). The range of mean diameters for the admixtures prepared with Soyacal and Intralipid were 0.283 to 0.310 micron and 0.314 to 0.351 micron, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

A clinical evaluation of safflower oil emulsion in total parenteral nutrition

A new intravenous safflower oil emulsion (Liposyn, Abbott) was administered to 23 patients receiving total parenteral nutrition. In a prospective clinical trial, 500 ml of the 10% emulsion was administered each day for a minimum of 10 days. Plasma fatty acid estimations showed a rise in linoleic acid in 22 patients, and a fall in triene/tetraene ratio ( a guide to the presence of essential fatty acid deficiency), in 17 patients within four days of commencement of the infusion. Administration of Liposyn prevented the development of biochemical evidence of essential fatty acid deficiency. There were no clinical side effects attributable to the emulsion. Elevation of serum triglyceride and liver enzyme concentrations occurred in some patients.