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Wheeless' Textbook of Orthopaedics
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Discussion of Lipids in the TPN patient





- Discussion:
    - requirements are met with 1.0-1.5 ml (2-3 bottles) of 10% lipid
          emulsion/week;
    - available as 10% or 20% solutions (1 or 2 kcal/cc);
    - important to check baseline measurements of triglycerides ( < 200)
          and check 8-12 hrs after infusion (to r/o hypertriglyceridemia);
    - safe to provide upto 25% total calories as lipid, but must never
          exceed 60%, and must not get > 2gm/kg/day;
    - infuse over 6-12 hr period (1st bottle: 1 ml/min for 15 min to check
          for a hypersensitivity reaction);
- Fat Emulsion:
    - 20% = 2 kcal/ml = 0.2 gm/ml

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A comparison of medium-chain and long-chain triglycerides in surgical
      patients.




Original Text by Clifford R. Wheeless, III, MD.