New Uses for a New Oil: Clinical Applications of Fish Oil Lipid Emulsion

Parenteral nutrition (PN) has been utilized as an essential therapeutic tool in healthcare for more than 5 decades. In United States, the prevalence of home parenteral nutrition (HPN) is estimated to be more than 25,000 patients. Intravenous lipids emulsions (ILEs) are a critically important component of PN as a source of calories and essential fatty acids. In order to provide a deeper understanding of the benefits and risks associated with use of fish oil (FO) containing ILE, this manuscript reviews the history of ILE development, unique benefits of FO, and the clinical data available for FO containing ILEs. Over the years, major developments have occurred in order to achieve a nontoxic and stable emulsion. Extensive research and product development led to the development of multiple generations of ILEs. FO containing ILEs, the latest ILE generation, were introduced as safe, effective, and beneficial emulsions with distinct properties and mechanisms of action. In this review, we describe ILEs development milestones, biological and metabolic benefits of FO containing ILEs, and key clinical outcome data with consensus key remarks as well as highlighting the challenges in clinical applications and gaps in literature.