Surveillance of adverse drug reactions from intravenous fat emulsions in a surgical ward

Objective: To survey the adverse drug reactions (ADR) from the intravenous administration of fat emulsions among surgical patients. The relationship between ADR and infusion rate was investigated. Design: We assessed, prospectively and consecutively, 144 patients receiving intravenous fat emulsions during a period of 10 months. The probability of ADR was estimated according to the Naranjo's ADR algorithm. Relationships between ADR and preparation composition (10% and 20%), infusion rate, and infusion route were analyzed. Results: Among the 95 patients that received 20% fat emulsions, ADR observed in 18 cases were categorized as highly probable and in 8 cases as possible. However, no ADR were seen in the group that received 10% fat emulsions. The average infusion rate in the patients that developed ADR categorized as highly probable (n = 18) was 0.346 ±0.151 g/kg/hr, whereas the average was 0.446 ± 0.092 g/kg/hr in the group with possible ADR (n = 8). The average infusion rate in the patients (n = 69) who did not develop ADR was 0.185 ± 0.143 g/kg/hr. The infusion rates were significantly higher in the patients with ADR (p < 0.001). Also, the percentage of ADR was closely associated with infusion rate. Conclusion: The risk of ADR from fat emulsions was associated with higher infusion rates. To prevent ADR from fat emulsions, an infusion rate less than 0.1 g/kg/hr was recommended.