Essential fatty acid deficiency in red cells after thermal injury: correction with intravenous fat therapy

Abstract
Significant reduction in the levels of linoleate, arachidonate, and docosahexaenoate in red cell membrane phospholipid has been described in five severely burned humans. With these decreases in essential polyunsaturated fatty acids there were concomitant increases in palmitate, oleate, and the 24-carbon species. Infusion of a soybean lipid emulsion corrected the imbalance of red cell lipid components in two patients, whereas a fat-free intravenous diet that provided comparable calories failed to restore to normal the altered fatty acid pattern of a third individual. In a fourth patient, oral feedings, high in essential fat, resulted in a rapid return to normal fatty acid distribution. Two nonburned patients with enterocutaneous fistulae receiving fat-free parenteral nutrition for 1 month or longer did not demonstrate significant alterations in red cell phospholipid fatty acids. With the restoration of normal fatty acid patterns, the abnormally low membrane lipid phosphorus levels and altered distribution of phospholipids also returned to within normal limits. The infusion of fat emulsion was without major consequence to the fatty acid composition of various plasma lipids.