Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition
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Compounding parenteral nutrition, either manually or with an automated compounding device, requires aseptic conditions and trained personnel. The revised version of United States Pharmacopeia Chapter <797> is a comprehensive document that describes standards and procedures to minimize the risk of contamination of compounded parenteral products. ⋯ Because parenteral nutrition is a compounded product mixed from multiple additives, it is important to maintain these standards, especially when using an automated compounding device. This article is an overview of United States Pharmacopeia Chapter <797>, with special emphasis on parenteral nutrition.
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Current evidence indicates that omega-3 polyunsaturated fatty acids (PUFAs), particularly eicosapentaenoic acid and docosahexaenoic acid found in fish oil, can prevent the development of inflammatory diseases by affecting different steps of the immune response. The capacity of omega-3 PUFAs to modulate synthesis of eicosanoids, activity of nuclear receptor and nuclear transcription factors, and production of resolvins may also mitigate inflammatory processes already present. Parenteral infusion of omega-3 PUFAs is advantageous, particularly in severely ill patients, because the fatty acids are rapidly incorporated by cells. ⋯ Other commercially available lipid emulsions contain fish oil in a fat mixture; one contains 10% fish oil and another 15% fish oil. Relevant experimental and clinical data from studies evaluating fish oil lipid emulsions are discussed in the present review. Administration of fish oil lipid emulsion, when compared with soybean oil lipid emulsion (rich in omega-6 PUFA), decreases the length of hospital and intensive care unit stay in surgical patients.