SMOFlipid versus Intralipid in Postoperative ICU Patients

Aim of the work Lipids are important components of total parentral nutrition, especially for patients after major abdominal surgery. Traditionally used intralipid has many complications and can lead to increased infection rate and sepsis, that is why, it is not indicated in cases with low immunity and sepsis. So, in this study, we compared the effect of intralipid and SMOFlipid on the level of IL-6, in addition to lipid profile, liver enzymes, coagulation profile and renal functions. Patients and Methods This prospective, randomized, double-blinded study was designed to compare between two groups of postsurgical ICU patients. Group I and group II had 42 and 41 patients respectively. Both the groups were given total parentral nutrition for not less than 7 days postoperatively. Group I was given Intralipid as a source of fat, and Group II was given SMOFlipid in substitution of intralipid. Vital signs (including blood pressure, heart rate, and body temperature), blood liver function test, renal function test, coagulation profile, white blood cells (WBCs), and lipid profile (triglycerides [TGs], cholesterol [CH], low-density lipoprotein [LDL], and high-density lipoprotein [HDL]) were monitored. The assessments for IL-6 was performed which indicate inflammatory response. The clinical outcomes, including morbidity, mortality, and infectious complications during the hospital stay, were also evaluated. Results The study showed no significant differences between the two groups with regard of vital signs and chemical profiles for cholesterol, triglycerides and liver enzymes. IL 6 levels were significantly different between the two groups on day 4 and 7. IL-6 was significantly lower in SMOFlipid group on day 4 and 7 than in intralipid group. Conclusion On comparing intralipid versus SMOFlipid, we have discovered that SMOFlipid group showed low level of IL6 which is as a single agent gives an indication of reduced inflammatory response with SMOFlipid but with a weak proof and need more studies for bigger scale of inflammatory indicators.