Omegaven

• Parenteral nutrition (as part of TPN)
• Preoperative and postoperative nutritional disturbances
• Burns (to reduce excessive nitrogen losses)
• Prolonged unconsciousness (cranial trauma, poisoning)
• Impaired renal function (to reduce protein breakdown)
• Essential fatty acid deficiency

Adult Dose (IV):

• As part of TPN: Fat emulsion should comprise no more than 60% of total caloric intake
• Initial infusion rate: 1 ml/min for first 15-30 min; increase to 2 ml/min if no adverse reactions
• Infuse only 500 ml the first day; increase dose the following day
• Do not exceed daily dosage of 2.5 g/kg
• Fatty acid deficiency correction: 8-10% of caloric intake by IV fat emulsion

Pediatric Dose (IV):

• Initial infusion rate: 0.1 ml/min for first 10-15 min; increase to 1 g/kg in 4 hours if no adverse reactions
• Do not exceed daily dosage of 3 g/kg
• Infants: Start at 0.5 g/kg/24 hours; max 3 g/kg/24 hours

Side Effects:

• Rise in body temperature (incidence <3%)
• Shivering, chills, nausea/vomiting (incidence <1%)
• Hypersensitivity reactions (anaphylactic reaction, skin rash, urticaria)
• Respiratory symptoms (tachypnoea)
• Circulatory effects (hypertension, hypotension)
• Thrombosis, hemolysis, abdominal pain, tiredness, headache, flushing, dyspnea, dizziness

Use in Pregnancy: Absolute safety of the fetus has not been established; administer with caution during pregnancy.

• Soya oil and egg lecithin may cause allergic reactions; cross-allergy between soya-bean and peanut observed
• Strong correlation between C-reactive protein and fat emulsion agglutination in seriously ill patients; administer with caution
• Caution in neonates and premature infants with hyperbilirubinaemia and suspected pulmonary hypertension
• In low birthweight infants, risk of lipid infusions may outweigh benefits due to diminished infection defence
• Monitor platelet count, liver function tests, and serum triglyceride in neonates on long-term parenteral nutrition