Clinical Guidelines

Regarding the Use of Alternative Intravenous Lipid Emulsions (ILEs)

ASPEN/SCCM Critical Care guidelines:

  • "Alternative IVFEs may provide outcome benefit over soy-based IVFEs; however, we cannot make a recommendation at this time due to lack of availability of these products in the United States."19
  • "When these alternative IVFEs (SMOF [soybean oil, MCT, olive oil, and fish oil emulsion], MCT, OO, and FO) become available in the United States, based on expert opinion, we suggest that their use be considered in the critically ill patient who is an appropriate candidate for PN."19

Canadian Critical Care Nutrition guidelines:

"When PN with IV lipids is indicated, IV lipids that reduce the load of ω-6 fatty acids/soybean oil emulsions should be considered."20

ESPEN guidelines for critically ill patients:

  • "Lipids should be an integral part of PN for energy to ensure essential fatty acid provision in long-term intensive care unit patients."21
  • "This may include fish oil-enriched and olive oil-based lipid emulsions."21

ESPEN guidelines for surgical patients:

  • "The optimal PN regimen for critically ill surgical patients should probably include supplemental ω-3 fatty acids."22


  1. McClave SA, et al. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2016;40(2):159-211.
  2. Heyland DK, et al. Canadian Clinical Practice Guidelines 2013 and 2015. Critical Care Nutrition website. Accessed December 18, 2015.
  3. Singer P, et al. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr. 2009;28(4):387-400.
  4. Braga M, et al. ESPEN Guidelines on Parenteral Nutrition: surgery. Clin Nutr. 2009;28(4):378-386.