Intravenous Fat Emulsion Administration and Short-Term Lipid Profiles Under a Standardized Clinical Pathway After Gastrectomy: A Retrospective Observational Study

Background/Objectives: Real-world data on intravenous fat emulsion administration and postoperative lipid profiles under standardized clinical pathways are limited. We described administration practices and short-term lipid profiles after gastrectomy. Methods: This single-center retrospective study included patients who underwent gastrectomy for gastric cancer between August and December 2020 and received postoperative fat emulsion. The pathway specified 50 g/day of a 20% soybean oil-based emulsion, starting on postoperative day (POD) 1, generally for five days. Dose, infusion duration, weight-adjusted infusion rate, and serum triglyceride (TG) and total cholesterol (T-Cho) levels were assessed descriptively. Lipid elevations were graded using the Common Terminology Criteria for Adverse Events version 5.0. Results: Among 89 patients, 85 received fat emulsion and were analyzed. The median infusion rate was 0.16 g/kg/h (range, 0.09–0.34); 83 patients (97.6%) received rates >0.1 g/kg/h, including 67 (78.8%) at >0.1 to ≤0.2 g/kg/h. No grade ≥2 TG or T-Cho elevations were observed in available measurements on POD 3 or POD 7. Median TG was 107.5 mg/dL before surgery and 119 mg/dL on POD 7; corresponding T-Cho values were 188 and 146 mg/dL. Outpatient TG measurements were available for only four patients. Conclusions: These findings describe short-term lipid profiles under a fixed-dose postoperative nutritional pathway. They do not establish the safety of infusion rates exceeding 0.1 g/kg/h or define a safe upper infusion-rate threshold.