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Abstract：
The infusion of lipid emulsions allows a high energy supply, facilitates the prevention of high glucose infusion rates and is indispensable for the supply with essential fatty acids. The administration of lipid emulsions is recommended within < or =7 days after starting PN (parenteral nutrition) to avoid deficiency of essential fatty acids. Low-fat PN with a high glucose intake increases the risk of hyperglycaemia. In parenterally fed patients with a tendency to hyperglycaemia, an increase in the lipid-glucose ratio should be considered. In critically ill patients the glucose infusion should not exceed 50% of energy intake. The use of lipid emulsions with a low phospholipid/triglyceride ratio is recommended and should be provided with the usual PN to prevent depletion of essential fatty acids, lower the risk of hyperglycaemia, and prevent hepatic steatosis. Biologically active vitamin E (alpha-tocopherol) should continuously be administered along with lipid emulsions to reduce lipid peroxidation. Parenteral lipids should provide about 25-40% of the parenteral non-protein energy supply. In certain situations (i.e. critically ill, respiratory insufficiency) a lipid intake of up to 50 or 60% of non-protein energy may be reasonable. The recommended daily dose for parenteral lipids in adults is 0.7-1.3 g triglycerides/kg body weight. Serum triglyceride concentrations should be monitored regularly with dosage reduction at levels >400 mg/dl (>4.6 mmol/l) and interruption of lipid infusion at levels >1000 mg/dl (>11.4 mmol/l). There is little evidence at this time that the choice of different available lipid emulsions affects clinical endpoints.
摘要：
脂质乳液的输注允许高能量供应，有助于预防高葡萄糖输注率，并且对于必需脂肪酸的供应是必不可少的。建议在开始PN（肠胃外营养）后<或=7天内施用脂质乳剂，以避免必需脂肪酸缺乏。高糖摄入的低脂肪PN会增加高血糖的风险。在有高血糖倾向的肠胃外喂养患者中，应考虑脂质-葡萄糖比率的增加.在危重患者中，葡萄糖输注不应超过能量摄入的50％。建议使用具有低磷脂/甘油三酯比例的脂质乳液，并应与通常的PN一起提供，以防止必需脂肪酸的消耗。降低高血糖的风险，预防肝脏脂肪变性.生物活性维生素E（α-生育酚）应与脂质乳剂一起连续施用以减少脂质过氧化。肠胃外脂质应提供约25-40%的肠胃外非蛋白质能量供应。在某些情况下（即病危，呼吸功能不全）脂质摄入量高达50％或60％的非蛋白质能量可能是合理的。成人肠胃外脂质的推荐日剂量为0.7-1.3g甘油三酯/kg体重。应定期监测血清甘油三酯浓度，并在>400mg/dl（>4.6mmol/l）的水平下减少剂量，并在>1000mg/dl（>11.4mmol/l）的水平下中断脂质输注。目前几乎没有证据表明选择不同的可用脂质乳剂会影响临床终点。
