Lipids in the intensive care unit: Recommendations from the ESPEN Expert Group
Open accessAbstract
This article summarizes the presentations given at an ESPEN Workshop on "Lipids in the ICU" held in Tel Aviv, Israel in November 2014 and subsequent discussions and updates. Lipids are an important component of enteral and parenteral nutrition support and provide essential fatty acids, a concentrated source of calories and building blocks for cell membranes. Whilst linoleic acid-rich vegetable oil-based enteral and parenteral nutrition is still widely used, newer lipid components such as medium-chain triglycerides and olive oil are safe and well tolerated. Fish oil (FO)-enriched enteral and parenteral nutrition appears to be well tolerated and confers additional clinical benefits, particularly in surgical patients, due to its anti-inflammatory and immune-modulating effects. Whilst the evidence base is not conclusive, there appears to be a potential for FO-enriched nutrition, particularly administered peri-operatively, to reduce the rate of complications and intensive care unit (ICU) and hospital stay in surgical ICU patients. The evidence for FO-enriched nutrition in non-surgical ICU patients is less clear regarding its clinical benefits and additional, well-designed large-scale clinical trials need to be conducted in this area. The ESPEN Expert Group supports the use of olive oil and FO in nutrition support in surgical and non-surgical ICU patients but considers that further research is required to provide a more robust evidence base.
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Propofol lipid solution contains 1.1 kcal/mL and can provide a large calorie load over and above nutritional support.
“This lipid solution contains 1.1 kcal/mL and can provide a large calorie load over and above nutritional support (201,202).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [202]
Citrate use in continuous veno-venous hemodiafiltration is associated with increased carbohydrate load.
“Citrate use in continuous veno-venous hemo-dia-filtration (CVVH) is also associated with increased carbohydrate load and should be taken into account as a non-nutritional calorie intake (202).”
From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [202]
The evidence for omega-3 FA-enriched emulsions in non-surgical ICU patients is not sufficient to recommend it as a standalone.
“At this stage, the evidence for omega-3 FA-enriched emulsions in non-surgical ICU patients is not sufficient to recommend it as a standalone [76]”
From ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit (2023) · cites this paper as [76]
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ESPEN guideline on clinical nutrition in the intensive care unit.
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Self-citationESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit
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Self-citation
- Authors
- Calder, P. C., Adolph, M., Deutz, N. E., Grau, T., Innes, J. K., Klek, S., Lev, S., Mayer, K., Michael-Titus, A. T., Pradelli, L., Puder, M., Vlaardingerbroek, H., & Singer, P.
- Affiliations
- University Hospital Southampton NHS Foundation Trust (GB)
- Universitätsklinikum Tübingen (DE)
- Texas A&M University (US)
- Hospital Universitario 12 De Octubre (ES)
- University of Southampton (GB)
- Tel Aviv University (IL)
- Universitätsklinikum Gießen und Marburg (DE)
- Queen Mary University of London (GB)
- Boston Children's Hospital (US)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Calder, Philip C.
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2018-02
- Volume
- 37
- Issue
- 1
- Pages
- 1-18
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2753023607
- Cited by
- 158
- References
- 11
- Citations by year
- 2026: 10 · 2025: 17 · 2024: 18 · 2023: 22 · 2022: 17 · 2021: 21 · 2020: 27 · 2019: 11 · 2018: 13 · 2017: 1 · 2016: 1
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Keywords
- lipid emulsions, enteral nutrition, parenteral nutrition, fish oil, olive oil, medium-chain triglycerides, linoleic acid, essential fatty acids, surgical intensive care unit, perioperative nutrition, anti-inflammatory activity, immunomodulation, ICU length of stay
- MeSH terms
- Critical Care, Enteral Nutrition, Fat Emulsions, Intravenous, Humans, Intensive Care Units, Lipids, Parenteral Nutrition, Critical Illness
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