[Development of an immuno-neutral lipid emulsion for optimal postoperative management of intensive care patients].

Lipid emulsions prolong the rejection of allogeneic rat heart grafts in relation to their n-3 to n-6 fatty acid ratio. Because of the predominance of n-6 fatty acids soybean oil, which is clinically applied, shows an immunosuppressive effect. An n-3 to n-6 fatty acid ratio of 1 to 2 proved to be immunoneutral. Intravenous fat emulsions with an impaired n-3 to n-6 fatty acid ratio reduce cytokine release, infiltration and proliferation of immunocompetent cells. Lipids rich in n-3 fatty acids additionally reduce the release of the potent vasoconstrictor thromboxane A3 and increase the synthesis of leukotriene B5, which unlike leukotriene B4 does not activate polymorphonuclear neutrophils. Based on our results, the production of a clinically applicable lipid emulsion with a n-3 to n-6 fatty acid ratio of 1 to 2 can be recommended for the optimal parenteral nutrition of ICU patients with a markedly reduced immune system.