Fatisol IV Infusion
Fatisol is a source of calories and essential fatty acids for patients requiring parenteral nutrition for extended periods of time (usually for >5 days). It is a source of essential fatty acids when a deficiency occurs. Part of the intravenous diet in all parenteral nutrition indications including:
- Preoperative and postoperative nutritional disturbances where an improved nitrogen balance is required;
- Nutritional disorders or disturbances of nitrogen balance due to inadequate or failing intestinal absorption caused by tumours in the gastrointestinal tract, acute or chronic intestinal diseases (peritonitis, ulcerative colitis, terminal ileitis);
- Burns, to reduce the frequently excessive nitrogen losses; Prolonged unconsciousness, eg. following cranial trauma or poisoning in cases where enteral feeding is inappropriate or impossible;
- Impaired renal function where a concentrated source of energy may be indicated to reduce protein breakdown;
- Cachexia and Patients with essential fatty acid deficiency who cannot maintain or restore a normal essential fatty acid pattern by oral intake.
Dosage & Administration
Total Parenteral nutrition: As a part of TPN, administer IV via a peripheral vein or by central venous catheter. Fat emulsion should comprise no more than 60% of the patient's total caloric intake, with carbohydrates and amino acids comprising the remaining 40% or more of caloric intake. Adult: Initial infusion rate is 1ml/min for the first 15 to 30 mins. If no adverse reactions occur, the infusion rate can be increased to 2 ml/min. Infuse only 500 ml the first day and increase dose the following day. Do not exceed a daily dosage of 2.5 g/kg. Children: Initial infusion rate is 0.1ml/min for the first 10 to 15 mins. If no adverse reactions occur, the infusion rate can be increased to 1g/kg in 4 hours. Do not exceed a daily dosage of 3 g/kg. Infants: Starts at 0.5g/kg/24 hours and may be increased in relation to the infant's ability to eliminate fat. The maximum recommended dosage is 3g/kg/24 hours. Fatty acid deficiency: To correct EFAD, supply 8% to 10% of the caloric intake by IV fat emulsion to provide an adequate amount of linoleic acid. The left over contents of opened bottles should be discarded & not saved for later use.Do not use any bottles in which there appears to be separation of the emulsion.
Route of Administration
Fatisol can be given by a peripheral or central vein, either alone or simultaneously with amino acid and/or glucose 10% to 30%, through a twin infusion set or separate sets connected to a single tap so that the mixture reaches the vein through the same cannula.
Fatisol contains soya oil and egg lecithin which may rarely cause allergic reactions. Cross allergic reaction has been observed between soya-bean and peanut. Fat metabolism may be disturbed in conditions such as renal insufficiency, uncompensated diabetes, pancreatitis, certain forms of liver insufficiency, metabolic disorders and sepsis. Fatisol should be administered with caution as a strong correlation exists between C-reactive protein and the agglutination of Fatisol in seriously ill patients. Fatisol should be given with caution to neonates and premature infants with hyperbilirubinaemia and in cases with suspected pulmonary hypertension. In low birthweight infants, the risk of lipid infusions may outweigh potential benefits due to further diminution of defences against infection. In infants, metabolism of lipids in peripheral tissues may be diminished by infection and heparin administration. In neonates receiving long term parenteral nutrition, particularly premature neonates, platelet count, liver function tests and serum triglyceride concentration should be monitored.
Use in Pregnancy & Lactation
Absolute safety of the foetus and the nursing infant has not been established. Therefore, Fatisol should be administered with caution during pregnancy and lactation.