Alternate Name(s):
INTRALIPID®
Classification:
Intravenous nutritional therapy, caloric agent
Original Date:
August 2005
Revised Date:
May 2017
Indications:
- Source of calories and essential fatty acids for patients needing parenteral nutrition
- Treatment for local anesthetic-induced cardiac arrest when standard resuscitation methods fail to re-establish sufficient circulatory stability
- Treatment for management of hemodynamic instability due to lidocaine toxicity
Reconstitution and Stability:
- Store at room temperature, avoid freezing
- Partly used bags should be discarded
- DO NOT USE if emulsion is oiling out
Compatibility:
- Solutions Compatible: D50W, 0.9% NaCl, ringer's lactate, amino acid solution
- Additives/Above Cassette Compatible: heparin (1-2 units/mL)
- Y-site Compatible: refer to Lexi/Micromedix IV compatibility information
- Incompatible: refer to Lexi/Micromedix IV compatibility information
Administration:
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
| SC | NO |
| IM | NO |
| IV Direct |
NO |
| IV Intermittent Infusion | NO |
| IV Continuous Infusion | YES, via peripheral or central vein Infusion rate: do not exceed 0.25 g/kg/hour (do not exceed 1.25 mL/kg/hour of 20% solution) |
Dosage:
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
Pediatric:
- Initiate at 0.5-1 g/kg/day;
- Increase by 0.5 g/kg/day
- Maximum: 3 g/kg/day
Adolescent/Adult:
- Initiate at 1 g/kg/day;
- Increase by 0.5-1 g/kg/day
- Maximum: 2.5 g/kg/day
- 30-35% of total daily calories should come from fat
- Maximum of 60% of total daily calories from fat emulsion
Treatment for local anesthetic-induced cardiac arrest/hemodynamic instability
- 20% IV dose regime: 1.5 mL/kg over 1 minute - follow with an infusion at rate of 15 mL/kg/hr
- continue infusion until hemodynamic stability is restored
- usual maximum infusion time 30 minutes and maximum total dose of 10 mL/kg
Potential hazards of parenteral administration:
- Cyanosis, flushing, chest or back pain
- Thrombophlebitis
- Sepsis
- Hyperlipidemia, hepatomegaly
- Dyspnea
- Fever, chills
- Nausea, vomiting
Notes:
- 20% lipid = 2 Kcal/mL
- Monitor serum triglycerides and free fatty acids
- May be administered both peripherally and centrally
- Contraindicated in pancreatitis with hyperlipidemia, lipoid nephrosis, and severe egg or soybean allergies
- Use with caution in patients with severe liver damage, pulmonary disease, anemia, or blood coagulation disorder, and in jaundiced patients
- Refer to SMOF monograph for SMOF information