• W Manzanares and P L Langlois.
• Cátedra de Medicina Intensiva, Hospital de Clínicas: Dr. Manuel Quintela, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay. Electronic address: wmanzanares@adinet.com.uy.
• Med Intensiva. 2016 Jan 1; 40 (1): 39-45.

AbstractThird-generation lipid emulsions (LE) are soybean oil sparing strategies with immunomodulatory and antiinflammatory effects. Current evidence supporting the use of intravenous (i.v) fish oil (FO) LE in critically ill patients requiring parenteral nutrition or receiving enteral nutrition (pharmaconutrient strategy) mainly derives from small phase ii clinical trials in heterogenous intensive care unit patient's population. Over the last three years, there have been published different systematic reviews and meta-analyses evaluating the effects of FO containing LE in the critically ill. Recently, it has been demonstrated that i.v FO based LE may be able to significantly reduce the incidence of infections as well as mechanical ventilation days and hospital length of stay. Nonetheless, more robust evidence is required before giving a definitive recommendation. Finally, we strongly believe that a dosing study is required before new phase iii clinical trials comparing i.v FO containing emulsions versus other soybean oil strategies can be conducted.Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

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