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肠外营养中的脂质:国际峰会会议记录和专家共识汇总

Summary of Proceedings and Expert Consensus Statements From the International Summit "Lipids in Parenteral Nutrition".

机构信息

Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA.

Pharmacy Service, Vall d'Hebron Barcelona Hospital Campus and Department of Nutrition, University of Barcelona, Barcelona, Spain.

出版信息

JPEN J Parenter Enteral Nutr. 2020 Feb;44 Suppl 1:S7-S20. doi: 10.1002/jpen.1746.

Abstract

BACKGROUND

The 2018 Lipids in Parenteral Nutrition summit involved a panel of experts in clinical nutrition, lipid metabolism, and pharmacology, to assess the current state of knowledge and develop expert consensus statements regarding the use of intravenous lipid emulsions in various patient populations and clinical settings. The main purpose of the consensus statements is to assist healthcare professionals by providing practical guidance on common clinical questions related to the provision of lipid emulsions as part of parenteral nutrition (PN).

METHODS

The summit was designed to allow interactive discussion and consensus development. The resulting consensus statements represent the collective opinion of the members of the expert panel, which was informed and supported by scientific evidence and clinical experience.

RESULTS

The current article summarizes the key discussion topics from the summit and provides a set of consensus statements designed to complement existing evidence-based guidelines. Lipid emulsions are a major component of PN, serving as a condensed source of energy and essential fatty acids. In addition, lipids modulate a variety of biologic functions, including inflammatory and immune responses, coagulation, and cell signaling. A growing body of evidence suggests that lipid emulsions containing ω-3 fatty acids from fish oil confer important clinical benefits via suppression of inflammatory mediators and activation of pathways involved in the resolution of inflammation.

CONCLUSIONS

This article provides a set of expert consensus statements to complement formal PN guideline recommendations.

摘要

背景

2018 年肠外营养脂质峰会涉及临床营养、脂质代谢和药理学方面的专家小组,以评估目前关于在各种患者人群和临床环境中使用静脉内脂肪乳剂的知识状况,并制定专家共识声明。共识声明的主要目的是通过提供与作为肠外营养(PN)一部分提供脂肪乳剂相关的常见临床问题的实用指导,为医疗保健专业人员提供帮助。

方法

峰会旨在允许进行互动讨论和达成共识。由此产生的共识声明代表了专家小组全体成员的集体意见,该意见得到了科学证据和临床经验的支持和补充。

结果

本文总结了峰会的主要讨论议题,并提供了一套旨在补充现有循证指南的共识声明。脂肪乳剂是 PN 的主要组成部分,是能量和必需脂肪酸的浓缩来源。此外,脂质调节多种生物学功能,包括炎症和免疫反应、凝血和细胞信号转导。越来越多的证据表明,含有鱼油 ω-3 脂肪酸的脂肪乳剂通过抑制炎症介质和激活参与炎症消退的途径,带来重要的临床益处。

结论

本文提供了一套专家共识声明,以补充正式的 PN 指南建议。

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