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The impact of overnight intravenous lipid emulsion (ILE) infusion on upper gastrointestinal tract physiology was assessed in 10 healthy volunteers. No changes in lower esophageal sphincter pressure (before infusion: 28 +/- 4 mm Hg; after infusion 20.5 +/- 3; p:NS), plasma concentrations of gastrointestinal hormones (gastrin: preprandial before/after lipids: 14 +/- 2.1/13 +/- 1.4 pM; postprandial before/after lipids: 28 +/- 2.7/30 +/- 3.4 pM, CCK: preprandial before/after lipids: 69 +/- 10/64 +/- 10 pM; postprandial before/after lipids: 96 +/- 11/95 +/- 12 pM; neurotensin: levels less than 6 pM in all samples; somatostatin levels undetectable in all samples) nor on pathologic gastroesophageal reflux episodes (% of time of pH less than 4, before/after lipids: 0.6 +/- 0.4/0.15 +/- 0.09), were found (p = NS). In contrast, technetium gastric emptying studies showed a significant delay when comparing pre- and post-lipid infusion values (37 +/- 4/54 +/- 4%) (p greater than 0.005). The mechanism of this effect remains unexplained.

Two different soy oil emulsions (Intralipid and Soyacal) were studied over a 2-week period in a random crossover study to determine if there were clinical or biochemical differences between the two preparations when used in patients requiring total parenteral nutrition (TPN). Each fat emulsion was infused randomly over 1 week and then switched to the other. Eighteen adult patients requiring a minimum of 14 days TPN were studied. None of the 26 metabolic parameters evaluated was statistically different between the two groups. Analysis of nutritional status, irrespective of lipid infused, showed that the patients who received 56 kcal/kg/day with 37% of the nonprotein calories from lipids (1.8 +/- 0.7 g/kcal/day) were in positive nitrogen balance on 80 of the 101 days studied. No adverse effects could be observed from either lipid emulsion during the short period of TPN used in this study. Both lipid emulsions were efficacious as a caloric source, and no clinical complications or biochemical abnormalities were found from either preparation.