Intralipid emulsion is an oil-in-water emulsion with high energy density, which can provide high calorie in a small volume, and is often used as parenteral nutrition and energy supplement. The significance of clinical application of intralipid emulsion is to provide essential fatty acids and energy to maintain the constant structure of human cells and adipose tissue, and it is a safe and effective nutrient. The main component of fat emulsion is triglyceride, and its physicochemical properties and physiological activity are determined by the fatty acids connected to the glycerol backbone. According to carbon chain length.
1. Long-chain fat emulsion
It consists of 14 to 24 carbon atoms. Long-chain fat emulsion is based on soybean oil and provides essential fatty acids for human body. The disadvantage is that the content of linoleic acid is too high, and the metabolism in the body is slow, which affects the function of granulocytes in the body, may increase the occurrence of infectious complications, and also has an inhibitory effect on the immune function of the body. Long-term use may cause fat pigmentation in the liver and spleen. At present, long-chain intralipid emulsions are mainly used in patients after abdominal trauma, and should be used with caution in patients with liver dysfunction, thrombosis, toxic shock, sepsis, acute respiratory distress syndrome, severe pancreatitis, and premature infants. or disabled.
2. Medium chain fat emulsion
It consists of 6 to 12 carbon atoms. Due to the short chain, medium-chain fat emulsion is more water-soluble than long-chain fat emulsion, has faster metabolism and energy supply, is not easy to accumulate in the liver, and is more suitable for patients with impaired liver function. Compared with traditional long-chain fatty emulsions, it can stimulate ketosis, and the production of ketone bodies is prone to acidosis. Therefore, it is necessary to limit the intake of medium-chain fatty emulsions in children with diabetes, acidosis or ketosis.
3. Medium and long chain fat emulsion
It consists of 6 to 24 carbon atoms. Medium and long chain fat emulsions are divided into physical mixing and chemical mixing:
(1) Physical mixing: that is, half weight of medium-chain fat emulsion and half weight of long-chain fat emulsion are mixed, and hydrolyzed and metabolized in their respective ways in the body.
(2) Chemical mixing: also known as structural mixing, that is, under the action of high temperature and enzyme catalysis, fatty acids of different chain lengths are randomly combined on the backbone of triglycerides. Structural fat emulsion not only avoids the drawbacks of medium chain fat emulsion overload, but also provides essential fatty acids, with good clinical tolerance and is also suitable for patients with liver insufficiency.
4. Short-chain fatty emulsions
It consists of only 2 to 4 carbon atoms. Short-chain fatty acids have the characteristics of promoting intestinal blood flow and stimulating the secretion of pancreatic enzymes, but they are not suitable as the main energy-supplying substances, and are currently only used in animal experiments and clinical trials.
5. Fish oil fat emulsion
Rich in omega-3 unsaturated fatty acids. Omega-3 fatty acids act as components of plasma and tissue lipids, and their metabolites inhibit the release of inflammatory mediators. When metabolizing in the body, granulocytes are less affected, reducing the occurrence of infectious complications. Fish oil fat emulsion also has the advantages of reducing the incidence of cardiovascular disease and improving immune function.