American Journal of Clinical Nutrition, Vol. 74, No. 2, 272-273,
August 2001
© 2001 American Society for Clinical Nutrition
Reply to MR Goldstein
Raffaele Marfella,
Francesco Nappo and
Dario Giugliano
Department of Geriatrics and Metabolic Diseases, Second University of Naples, Piazza Miraglia, 2 80138, Naples, Italy, E-mail: dario.giugliano{at}unina2.it
Dear Sir:
We are grateful to Goldstein for his interesting comment regarding the potential risk associated with infusion of fat emulsions in critically ill patients. As he correctly stated, patients requiring parenteral nutrition may be at increased risk of acquired prolongation of the Q-T interval as the result of either drug administration or electrolyte disturbances. In theory, an increased susceptibility to prolongation of the Q-T interval with infusion of fat emulsions may augment the risk of cardiac arrhythmias and sudden death; in practice, there is a surprising lack of information about this association. We agree that the Q-T interval should be monitored in patients receiving parenteral nutrition, particularly in those with additional risk factors for acquired prolongation of the Q-T interval. Additional studies are needed to characterize in full the risk of Q-T interval prolongation during parenteral nutrition in hospitalized patients.
