CoChat
Sign Up
Cited by 77Clinical Nutrition and GastroenterologyHyperglycemia and glycemic control in critically ill and hospitalized patientsCentral Venous Catheters and Hemodialysis

A double-blind, randomized clinical trial comparing soybean oil–based versus olive oil–based lipid emulsions in adult medical–surgical intensive care unit patients requiring parenteral nutrition*

Open access
Umpierrez, Guillermo E., Spiegelman, Ronnie, Zhao, Vivian, Smiley, Dawn D., Pinzon, Ingrid, Griffith, Daniel P., Peng, Limin, Morris, Timothy +5 more·2012·Critical Care Medicine
DOI 10.1097/ccm.0b013e3182474bf9PMC PMC3738173
Open this paper in CoChat — free account

Abstract

OBJECTIVE: Parenteral nutrition has been associated with metabolic and infectious complications in intensive care unit patients. The underlying mechanism for the high risk of complications is not known but may relate to the proinflammatory effects of soybean oil-based lipid emulsions, the only Food and Drug Administration-approved lipid formulation for clinical use. DESIGN: Prospective, double-blind, randomized, controlled trial. SETTING: Medical-surgical intensive care units from a major urban teaching hospital and a tertiary referral university hospital. PATIENTS: Adult medical-surgical intensive care unit patients. INTERVENTION: Parenteral nutrition containing soybean oil-based (Intralipid) or olive oil-based (ClinOleic) lipid emulsions. MEASUREMENTS: Differences in hospital clinical outcomes (nosocomial infections and noninfectious complications), hospital length of stay, glycemic control, inflammatory and oxidative stress markers, and granulocyte and monocyte functions between study groups. RESULTS: A total of 100 patients were randomized to either soybean oil-based parenteral nutrition or olive oil-based parenteral nutrition for up to 28 days. A total of 49 patients received soybean oil-based parenteral nutrition (age 51 ± 15 yrs, body mass index 27 ± 6 kg/m2, and Acute Physiology and Chronic Health Evaluation II score 15.5 ± 7 [±SD]), and a total of 51 patients received olive oil-based lipid emulsion in parenteral nutrition (age 46 ± 19 yrs, body mass index 27 ± 8 kg/m2, and Acute Physiology and Chronic Health Evaluation II score 15.1 ± 6 [±SD]) for a mean duration of 12.9 ± 8 days. The mean hospital blood glucose concentration during parenteral nutrition was 129 ± 14 mg/dL, without differences between groups. Patients treated with soybean oil-based and olive oil-based parenteral nutrition had a similar length of stay (47 ± 47 days and 41 ± 36 days, p = .49), mortality (16.3% and 9.8%, p = .38), nosocomial infections (43% vs. 57%, p = .16), and acute renal failure (26% vs. 18%, p = .34). In addition, there were no differences in inflammatory and oxidative stress markers or in granulocyte and monocyte functions between groups. CONCLUSION: The administration of parenteral nutrition containing soybean oil-based and olive oil-based lipid emulsion resulted in similar rates of infectious and noninfectious complications and no differences in glycemic control, inflammatory and oxidative stress markers, and immune function in critically ill adults.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1097/ccm.0b013e3182474bf9

Cites

2 of 2 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Meta-analyses have shown an advantage to lipid emulsions enriched in fish oil or olive oil.

    “Meta-analyses have shown an advantage to lipid emulsions enriched in fish oil or olive oil (254).”

    From ESPEN guideline on clinical nutrition in the intensive care unit. (2019) · cites this paper as [254]

    The Discussion (page unavailable) reports similar clinical outcomes for olive oil– and soybean oil–based emulsions, not an advantage for olive oil. The cited paper is a randomized trial, and the passages found do not report a meta-analysis showing an advantage for fish oil– or olive oil–enriched emulsions. (LLM, conf=0.82)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 42

  1. [1]Giner M Laviano A Meguid MM In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists Nutrition 1996 12 23 29 8838832
  2. [2]Daley J Khuri SF Henderson W Risk adjustment of the postoperative morbidity rate for the comparative assessment of the quality of surgical care: Results of the National Veterans Affairs Surgical Risk Study J Am Coll Surg 1997 185 328 340 9328381
  3. [3]Warnold I Lundholm K Clinical significance of preoperative nutritional status in 215 noncancer patients Ann Surg 1984 199 299 305 6703791 PMC1353396
  4. [4]Dempsey DT Mullen JL Buzby GP The link between nutritional status and clinical outcome: Can nutritional intervention modify it? Am J Clin Nutr 1988 47 2 Suppl 352 356 3124596
  5. [6]Correia MI Waitzberg DL The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis Clin Nutr 2003 22 235 239 12765661
  6. [7]Martindale RG Cresci G Preventing infectious complications with nutrition intervention JPEN J Parenter Enteral Nutr 2005 29 1 Suppl S53 S56 15709545
  7. [8]Strickland A Brogan A Krauss J Is the use of specialized nutritional formulations a cost-effective strategy? A national database evaluation JPEN J Parenter Enteral Nutr 2005 29 1 Suppl S81 S91 15709550
  8. [9]Waitzberg DL Torrinhas RS Jacintho TM New parenteral lipid emulsions for clinical use JPEN J Parenter Enteral Nutr 2006 30 351 367 16804134
  9. [10]Marik PE Zaloga GP Meta-analysis of parenteral nutrition versus enteral nutrition in patients with acute pancreatitis BMJ 2004 328 1407 15175229 PMC421778
  10. [11]Ziegler TR Parenteral nutrition in the critically ill patient N Engl J Med 2009 361 1088 1097 19741230 PMC3064749
  11. [12]Müller JM Brenner U Dienst C Preoperative parenteral feeding in patients with gastrointestinal carcinoma Lancet 1982 1 68 71 6119492
  12. [13]The Veterans Affairs Total Nutrition Cooperative Study Group Perioperative total parenteral nutrition in surgical patients N Engl J Med 1991 325 525 532 1906987
  13. [14]Detsky AS Baker JP O’Rourke K Perioperative parenteral nutrition: A meta-analysis Ann Intern Med 1987 107 195 203 3111322
  14. [15]Zaloga GP Parenteral nutrition in adult inpatients with functioning gastrointestinal tracts: Assessment of outcomes Lancet 2006 367 1101 1111 16581410
  15. [16]Gramlich L Kichian K Pinilla J Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients? A systematic review of the literature Nutrition 2004 20 843 848 15474870
  16. [17]Peter JV Moran JL Phillips-Hughes J A metaanalysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients Crit Care Med 2005 33 213 220 discussion 260 15644672
  17. [18]der Voort PH Feenstra RA Bakker AJ Intravenous glucose intake independently related to intensive care unit and hospital mortality: An argument for glucose toxicity in critically ill patients Clin Endocrinol (Oxf) 2006 64 141 145 16430711
  18. [19]Cheung NW Napier B Zaccaria C Hyperglycemia is associated with adverse outcomes in patients receiving total parenteral nutrition Diabetes Care 2005 28 2367 2371 16186264
  19. [20]Schloerb PR Glucose in parenteral nutrition: A survey of U.S. medical centers JPEN J Parenter Enteral Nutr 2004 28 447 452 15568294
  20. [21]Yaqoob P Lipids and the immune response: From molecular mechanisms to clinical applications Curr Opin Clin Nutr Metab Care 2003 6 133 150 12589183
  21. [22]Yaqoob P Monounsaturated fatty acids in parenteral nutrition; evaluation of risks and benefits Br J Nutr 2005 94 867 868 16351759
  22. [23]Buenestado A Cortijo J Sanz MJ Olive oil-based lipid emulsion’s neutral effects on neutrophil functions and leukocyte-endothelial cell interactions JPEN J Parenter Enteral Nutr 2006 30 286 296 16804125
  23. [24]Sala-Vila A Barbosa VM Calder PC Olive oil in parenteral nutrition Curr Opin Clin Nutr Metab Care 2007 10 165 174 17285004
  24. [25]Horan TC Andrus M Dudeck MA CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting Am J Infect Control 2008 36 309 332 18538699
  25. [26]Garcia-de-Lorenzo A Denia R Atlan P Parenteral nutrition providing a restricted amount of linoleic acid in severely burned patients: A randomised double-blind study of an olive oil-based lipid emulsion v. medium/long-chain triacylglycerols Br J Nutr 2005 94 221 230 16115356
  26. [27]Yaqoob P Monounsaturated fats and immune function Proc Nutr Soc 1998 57 511 520 10096110
  27. [28]McCowen KC Friel C Sternberg J Hypocaloric total parenteral nutrition: Effectiveness in prevention of hyperglycemia and infectious complications–a randomized clinical trial Crit Care Med 2000 28 3606 3611 11098961
  28. [29]Garner JS Jarvis WR Emori TG CDC definitions for nosocomial infections, 1988 Am J Infect Control 1988 16 128 140 2841893
  29. [30]The Acute Respiratory Distress Syndrome Network Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome N Engl J Med 2000 342 1301 1308 10793162
  30. [31]Jones DP Liang Y Measuring the poise of thiol/disulfide couples in vivo Free Radic Biol Med 2009 47 1329 1338 19715755 PMC2774737
  31. [32]Pasquel FJ Spiegelman R McCauley M Hyperglycemia during total parenteral nutrition: An important marker of poor outcome and mortality in hospitalized patients Diabetes Care 2010 33 739 741 20040658 PMC2845017
  32. [33]Anderson AD Jain PK MacFie J Parenteral nutrition in the critically ill Intensive Care Med 2003 29 2103 14534779
  33. [34]Heyland DK Montalvo M MacDonald S Total parenteral nutrition in the surgical patient: A meta-analysis Can J Surg 2001 44 102 111 11308231
  34. [35]Klein S Kinney J Jeejeebhoy K Nutrition support in clinical practice: Review of published data and recommendations for future research directions. Summary of a conference sponsored by the National Institutes of Health, American Society for Parenteral and Enteral Nutrition, and American Society for Clinical Nutrition Am J Clin Nutr 1997 66 683 706 9280194
  35. [36]Calder PC Hot topics in parenteral nutrition. Rationale for using new lipid emulsions in parenteral nutrition and a review of the trials performed in adults Proc Nutr Soc 2009 68 252 260 19426581
  36. [37]Umpierrez GE Smiley D Robalino G Intravenous intralipid-induced blood pressure elevation and endothelial dysfunction in obese African-Americans with type 2 diabetes J Clin Endocrinol Metab 2009 94 609 614 19001516 PMC2646518
  37. [38]Roden M Price TB Perseghin G Mechanism of free fatty acid-induced insulin resistance in humans J Clin Invest 1996 97 2859 2865 8675698 PMC507380
  38. [39]Gosmanov AR Smiley DD Robalino G Effects of oral and intravenous fat load on blood pressure, endothelial function, sympathetic activity, and oxidative stress in obese healthy subjects Am J Physiol Endocrinol Metab 2010 299 E953 E958 20923960 PMC3006255
  39. [40]Siqueira J Smiley D Newton C Substitution of standard soybean oil with olive oil-based lipid emulsion in parenteral nutrition: Comparison of vascular, metabolic, and inflammatory effects J Clin Endocrinol Metab 2011 96 3207 3216 21832112 PMC3200250
  40. [41]McClave SA Martindale RG Vanek VW A.S.P.E.N. Board of Directors; American College of Critical Care Medicine; Society of Critical Care Medicine: Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) JPEN J Parenter Enteral Nutr 2009 33 277 316 19398613
  41. [42]van den Berghe G Wouters P Weekers F Intensive insulin therapy in the critically ill patients N Engl J Med 2001 345 1359 1367 11794168
  42. [44]Finfer S Chittock DR Su SY NICE-SUGAR Study Investigators: Intensive versus conventional glucose control in critically ill patients N Engl J Med 2009 360 1283 1297 19318384

Cited by

Sorted by citations

Authors
Umpierrez, G. E., Spiegelman, R., Zhao, V., Smiley, D. D., Pinzon, I., Griffith, D. P., Peng, L., Morris, T., Luo, M., Garcia, H., Thomas, C., Newton, C. A., & Ziegler, T. R.
Affiliations
Emory University (US)
Corresponding author
Umpierrez, Guillermo E.
ORCID
Venue
Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2012-06
Volume
40
Issue
6
Pages
1792-1798
ISSN
0090-3493 (ISSN-L)
DOI
10.1097/ccm.0b013e3182474bf9
PMC
PMC3738173
OpenAlex
W1964792635
Cited by
77
References
2
Citations by year
2026: 1 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 6 · 2020: 5 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 9 · 2015: 7 · 2014: 17 · 2013: 10 · 2012: 4
FWCI
11.35
Type
journal article
Language
en
Open access
Locations
  • Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR000454)
  • National Institute of Diabetes and Digestive and Kidney Diseases (K08-DK-0830361, K08DK083036)
  • National Center for Research Resources (UL1RR025008, K24RR023356)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
  • Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
Keywords
parenteral nutrition, lipid emulsions, soybean oil, olive oil, Intralipid, ClinOleic, intensive care unit patients, nosocomial infections, acute kidney injury, inflammatory markers, oxidative stress, granulocyte function, monocyte function, glycemic control, length of hospital stay, mortality, critically ill adults
MeSH terms
Olive Oil, Adult, Aged, Critical Care, Double-Blind Method, Fat Emulsions, Intravenous, Female, Humans, Intensive Care Units, Male, Middle Aged, Parenteral Nutrition, Plant Oils, Prospective Studies, Soybean Oil, Surgical Procedures, Operative, Treatment Outcome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review