A prospective, randomized trial of intravenous fat emulsion administration in trauma victims requiring total parenteral nutrition

F. D. Battistella, J. T. Widergren, John T Anderson, J. K. Siepler, J. C. Weber, K. MacColl, J. Ali, C. E. Wiles, F. A. Moore, M. Moncure

Research output: Contribution to journalArticle

200 Scopus citations


Objective: Intravenous fat infusions are a standard component of total parenteral nutrition (TPN). We studied the effects of withholding fat infusions in trauma patients requiring TPN. Design: Polytrauma patients receiving TPN were randomized to receive a standard fat emulsion dose (L) or to have fat infusions withheld (NL) for the first 10 days of TPN. The two groups received the same amino acid and carbohydrate dose (isonitrogenous, nonisocaloric). Materials and Methods: Clinical outcome parameters were measured. T-cell function was assessed by measuring lymphokine activated killer and natural killer cell activity. Measurements and Main Results: Demographics including Injury Severity Score (27 ± 8; 30 ± 9) and APACHE II scores (23 ± 6; 22 ± 5) were similar for the L (n = 30) and NL (n = 27) groups, respectively. Differences (p < 0.05) were found in length of hospitalization (L = 39 ± 24; NL = 27 ± 16), intensive care unit length of stay (L = 29 ± 22; NL = 18 ± 12), and days on mechanical ventilation (L = 27 ± 21; NL = 15 ± 12). The L group had a higher number of infections (72 in 30) than the NL group (39 in 27) and T-cell function was depressed in this group. Conclusions: Intravenous fat emulsion infusions during the early postinjury period increased susceptibility to infection, prolonged pulmonary failure, and delayed recovery in critically injured patients. It is not clear whether the improved outcome in the NL group was directly related to withholding the fat infusions or due to the hypocaloric nutritional regimen (underfeeding) these patients received.

Original languageEnglish (US)
Pages (from-to)52-60
Number of pages9
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number1
StatePublished - 1997



  • Lipid emulsion
  • Lymphocyte function
  • Lymphokine activated killer cells
  • Natural killer cells
  • Soybean oil emulsion
  • Total parenteral nutrition, Intravenous fat emulsion
  • Trauma
  • Underfeeding

ASJC Scopus subject areas

  • Surgery

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