Intralipid 20% Mechanism of Action

Pharmacology: Pharmacodynamics: Intralipid 20% provides essential and non-essential long-chain fatty acids for energy metabolism and apposition in cell membranes.
Intralipid 20% in the recommended dosage does not cause any hemodynamic changes. No clinically significant changes in pulmonary function have been described when Intralipid 20% is used properly. The transient increase in liver enzymes seen in some patients on total parenteral nutrition (TPN) including Intralipid 20% is reversible and disappears when TPN is interrupted. Similar changes are also seen in parenteral nutrition without fat emulsions.
Pharmacokinetics: Intralipid 20% has biological properties similar to those of endogenous chylomicrons. Unlike chylomicrons, Intralipid 20% does not contain cholesterol esters or apolipoproteins, while its phospholipid content is significantly higher.
Intralipid 20% is eliminated from the circulation via the same pathway as endogenous chylomicrons, at least early-on in the catabolism. The exogenous fat particle is hydrolysed in the circulation and taken up by low-density lipoproteins (LDL) receptors peripherally and by the liver. The elimination rate is determined by the composition of the fat particles, nutritional status, disease and rate of infusion. In healthy volunteers, the maximum clearance rate of Intralipid 20% after fasting overnight is equivalent to 3.8±1.5 g triglycerides/kg body weight/24 hrs.
Both the elimination and the oxidation rates are dependent on the patient's clinical condition; elimination is faster and utilisation is increased in postoperative patients and in trauma, while patients with renal failure and hypertriglyceridemia show lower utilisation of exogenous fat emulsions.