Warning

SMOF lipid solution

  • This is a composite intravenous lipid emulsion (ILE) which is comprised of Soya Bean (30%), Medium chain triglycerides (30%), Olive Oil (25%) and Fish oil (15%) with vitamins added also
  • Water soluble vitamins (Solivito) and fat-soluble vitamins (Vitlipid) are added to 20% SMOF lipid to make the SMOF lipid solution
  • Start on day 1 unless it is contraindicated
  • The daily SMOF lipid solution dose is infused over 24 hours (there is no evidence of benefit in having a lipid free interval prior to morning blood sampling)
  • Essential fatty acid (EFA) deficiency can occur in preterm infants within 2-3 days if an adequate volume of lipid is not given. Infants require at least 0.25g/kg/day of Linoleic acid which is met with 1.5g/kg/day of SMOF lipid solution/day (0.375ml/kg/hour)

Table 2.0: Volume of SMOF lipid solution prescription

Day

Volume of SMOF lipid solution
ml/kg/hr

Fat provided from SMOF lipid solution

g/kg/day (approx.)

1

0.5

2

 

2

0.5

2

 

3

0.75

3

 

4

0.83

3.5

 

  • If starting PN > 4 days after birth lipid can be given at 3-4g/kg/day on the first day (NICE 2018)
  • Lipid intake should not exceed 4g lipid/kg for term or preterm infants

Editorial Information

Last reviewed: 01/10/2022

Next review date: 01/10/2032

Author(s): Hester Blair, Caroline O'Hare, David Quine, Angela Davidson, Clare Abbott-Smith.