Intravenous lipid dose and incidence of bacteremia and fungemia in patients undergoing bone marrow transplantation.

摘要: Experimental data have implicated intravenous lipids as being immunosuppressive, yet evidence that are associated with an increase in clinically documented infections is sparse. A prospective trial conducted patients hematologic malignancies who were undergoing bone marrow transplantation compared the incidence of bacteremia and fungemia during first month after transplant. Patients (n = 512) randomly assigned to receive 6-8% (low dose) or 25-30% (standard total daily energy a 20% lipid emulsion. An adaptive randomization scheme stratified for treatments might influence infection outcome (hematopoietic growth factors, fluconazole, graft-versus-host disease prophylaxis steroids, pentoxifylline, immunoglobulin, body irradiation). The transplant type (autologous, related family donor, unrelated donor) did not differ distribution between treatment groups. Of evaluable 482), 55 standard-dose group developed 54 low-dose group. log-rank test comparing time found no association (P 0.95). Similar results when analyzed intent-to-treat 0.98), bacterial fungal at all sites included 0.94), observation period was extended 60 d 0.58 blood infections, P 0.77 sites). These indicate moderate amounts rich linoleic acid increased receiving parenteral nutrition.