Short-term effects of parenteral nutrition of cholestatic infants with lipid emulsions based on medium-chain and long-chain triacylglycerols

Use of Total Parenteral Nutrition (TPN) as a Vehicle for Drug Delivery

Total Parenteral Nutrition (TPN) is a method of providing nutrients directly into the bloodstream for individuals who are unable to meet their nutritional needs through the normal digestive process or gastrointestinal system. It provides macronutrients and micronutrients in a single container, reducing handling and contamination risks and making it more cost-effective. TPN has the potential to be used as a drug delivery system, with applications in combination therapies, personalized medicine, and integrating advanced technologies. It can enhance drug dosage precision and provide nutritional assistance, potentially reducing hospitalization and improving patient outcomes. However, implementing new applications requires thorough testing and regulatory approval. TPN could be particularly useful in pediatric and geriatric care and could also contribute to global health by combating malnutrition in areas with limited medical resources. Healthcare professionals prepare a sterile solution tailored to each patient's nutritional needs, and administration involves a central venous catheter. However, the simultaneous administration of medications with PN admixtures can result in pharmacological incompatibility, which can impact the stability of the oil-in-water system. The European Society for Clinical Nutrition and Metabolism and the American Society for Parenteral and Enteral Nutrition recommendations advise against including non-nutrient drugs in PN admixtures due to safety concerns. This review focuses on the utilization of Total Parenteral Nutrition (TPN) as a method for delivering drugs. It discusses the benefits and difficulties associated with its commercial application and offers suggestions for future research endeavors.

Interfacial compositions of fat globules modulate structural characteristics and lipolysis of its model emulsions during in-vitro digestion

BACKGROUND

This study investigated whether milk fat globule membrane as an emulsifier could make fat easier for infants to digest. An emulsion was formed using the membrane material, where anhydrous milk fat was used as the core material, milk fat globule membrane polar lipid (MPL) as the emulsifier, and soybean phospholipid (PL) and milk protein concentrate (MPC) incorporated as control emulsifiers. Structural characterization, glyceride composition, and fatty acid release from emulsions by in vitro digestion were investigated.

RESULTS

The average particle size at the end of intestinal digestion was in the order MPL < PL < MPC, with diameters of 3.41 ± 0.51 μm, 3.53 ± 0.47 μm, and 10.46 ± 2.33 μm respectively. Meanwhile, laser scanning confocal microscopy results also illustrated that MPL could reduce the degree of aggregation during digestion. The lipolysis degree of MPL emulsion was higher than that of PL and MPC emulsions. MPL not only released higher levels of long-chain fatty acids, such as C18:1, C18:2, C18:3, which are of great significance for infant growth and development, but also released increased levels of C20:4 (arachidonic acid) and C22:6 (docosahexaenoic acid) than PL and MPC emulsions did.

CONCLUSION

Fat droplets enveloped by milk fat globule MPLs were easier to digest and are therefore more suitable for infant formula. © 2023 Society of Chemical Industry.

A detailed guide to lipid therapy in intestinal failure

Intravenous lipid emulsions are an integral part of nutrition therapy in the intestinal failure patient. In addition to being a concentrated source of non-protein calories, they provide the essential fatty acids necessary for growth and development. Depending upon the oil source used in these products, complications such as intestinal failure associated liver disease (IFALD) can occur. This review will discuss the risks and benefits associated with these products, especially as they relate to the pediatric intestinal failure patient.