The increased risk for infectious complications, mainly in the
form of catheter-related sepsis, is still a reason for concern in
patients treated with home parenteral nutrition (HPN). These
infections establish a potentially life-threatening hazard that has
a profound impact on the patients’ quality of life as well as on
hospital resources. In addition, repeated catheter loss eventually
compromises the options to obtain adequate venous access. 1
Despite technical improvements, training of patients and medical
staff in aseptic catheter handling, and the use of antiseptic catheter
locks, which have decreased infection rates to some extent, the
problem is still not solved. 1,2 In addition, it remains unclear
whether parenteral nutrition (PN) components, and especially
lipids, apart from the presence of a venous access device contribute
to the infection risk in HPN patients.Since the introduction of PN, several lipid emulsions based on
different oil sources have been developed that have shown distinct
effects on immune function. 3 The first emulsion (Intralipid ? ) that became available in the early 1960s was based only on soybean oil
(SO). This emulsion is still extensively used worldwide despite
concerns with regard to its pro-inflammatory profile due to the
high amount of n-6 fatty acids, specifically linoleic acid. To decrease
the amount of n-6 fatty acids, several emulsions have been devel-
oped in which SO is partly replaced by one or more alternative oils.
These mixtures of SO, fish oil (FO), olive oil (OO) and/or coconut oil
(CO) seem to have less pro-inflammatory effects and to modulate
immune function in a more beneficial way.