fat emulsion (Travamulsion)

Indications

• source of calories & essential fatty acids for patients requiring parenteral nutrition of extended duration

Contraindications

Caution:

• observe for hypersensitivity reactions at onset of therapy

Dosage

• should NOT exceed 60% of total daily calories
• premature infants
  • start: 0.25-0.5 g/kg/day
  • increase by 0.25-0.5 g/kg/day to max of 3-4 g/kg/day
  • maximum infusion rate: 0.15 g/kg/hour
• infants & children
  • start: 0.5-1.0 g/kg/day
  • increase by 0.5 g/kg/day to max of 3-4 g/kg/day
  • maximum infusion rate: 0.25 g/kg/hour (50 mL/hr of 20% solution)
• adolescents & adults
  • start: 1.0 g/kg/day
  • increase by 0.5-1.0 g/kg/day to max of 2.5 g/kg/day
  • maximum infusion rate: 0.25 g/kg/hour (50 mL/hr of 20% solution)
• children & adults with fatty acid deficiency:
  • infuse 8-10% of daily caloric intake 1-2 times/week

Injection: 10% (500 mL); 20% (500 mL).

Adverse effects

• common (> 10%)
  • thrombophlebitis
• less common (1-10%)
  • hyperlipidemia
• uncommon (< 1%)
  • cyanosis, hepatomegaly, dyspnea, sepsis, nausea/vomiting, diarrhea, flushing, chest pain

More general terms

• pharmacologic combination

Components

• fatty acid