Beisbarth H, Schultis K
Infusionsther Klin Ernahr. 1976 Feb;3(1):24-31.
Efficiency and tolerance of parenteral fat emulsions are determined essentially by the fate of the fat particles after entry into the circular system. - Although small quantitatively, unwanted phagocytosis by the reticulo endothelial system which may occur must not be disregarded and may lower the state of resistance of the organism. However, the plasma is mainly cleared of emulgated fat by extracellular liberation of fatty acids, the smaller part of which is oxidized immediately, the major part being reesterified to storage fat in adipose tissues by energy requiring process. - In order to avoid an "overloading syndrome" because of saturation of these mechanisms-which is easily possible-recommended dosages must not be exceeded (up to 30% of total daily calories in normal adults, up to 50% in infants, maximum infusion rate 150 mg/kg body weight and hour). - Achievable efficiencies of parenteral fat emulsions can be preestimated roughly depending on parameters of the individual cases. The most important ones among these parameters are the amount and the differently activated intracellular mobilisation of the body's own fat stores in relation to its oxidative capacity or requirement, resp. The indications which result from the efficiencies estimated individually are identical from the viewpoints of application of essential fatty acids as well as of fat emulsions as a calorie source (figure 7a and b).
胃肠外脂肪乳剂的效率和耐受性基本上取决于脂肪颗粒进入循环系统后的命运。——尽管数量上很少，但网状内皮系统可能发生的不必要的吞噬作用不容忽视，它可能会降低机体的抵抗力。然而，血浆中乳化脂肪的清除主要是通过脂肪酸的细胞外释放，其中较小一部分立即被氧化，大部分通过耗能过程重新酯化为脂肪组织中的储存脂肪。——为了避免因这些机制饱和而导致的“过载综合征”（这很容易发生），推荐剂量不得超过（正常成年人不超过每日总热量的30%，婴儿不超过50%，最大输注速率为150毫克/千克体重·小时）。——胃肠外脂肪乳剂可达到的效率可根据个体情况的参数大致预先估计。这些参数中最重要的是机体自身脂肪储备相对于其氧化能力或需求的数量和不同程度的细胞内动员。从必需脂肪酸的应用以及脂肪乳剂作为热量来源的角度来看，根据个体估计效率得出的适应证是相同的（图7a和b）。
