John Libbey Eurotext

European Journal of Dermatology

Impact of intravenous lipid emulsion infusion on the stratum corneum barrier function in patients receiving parenteral nutrition Article à paraître

University Lyon 1, Claude Bernard, EA 4169 Fonctions Physiologiques et Pathologiques de la Barrière Cutanée, Faculty of Pharmacy, Lyon, France, and Plateforme FRIPHARM, Edouard Herriot Hospital, Hospices Civils de Lyon, Pharmacy, Lyon, France and Plateforme FRIPHARM, Croix-Rousse Hospital, Hospices Civils de Lyon, Clinical Nutrition Intensive Care Unit, Lyon, France, Croix-Rousse Hospital, Hospices Civils de Lyon, Hepato-Gastroenterology, Lyon, France
  • Mots-clés : essential fatty acids, intravenous lipid emulsion, skin barrier function, stratum corneum, transepidermal water loss
  • DOI : 10.1684/ejd.2013.1978

The importance of the lipid matrix of stratum corneum (SC) in epidermal barrier function is well documented. Intravenous lipid emulsions (ILE) provide essential fatty acids (EFAs), main components of the SC lipid matrix. The objective of this study was to investigate the influence of ILE upon SC barrier function.

The skin barrier was assessed by measuring transepidermal water loss (TEWL). Patients receiving lipid-containing parenteral nutrition (LCPN) were compared to patients receiving lipid-free PN (LFPN). In addition, a before/after LCPN introduction study was set up to limit the influence of inter-individual variability.

Twenty-six patients receiving LCPN and seven patients receiving LFPN were included. Median age was not significantly different between the two groups. The TEWL of the LCPN group (9.05 g/m2/h) was significantly lower than the TEWL of the LFPN group (12.1 g/m2/h; Wilcoxon test: p = 0.016). The relative variation of TEWL before and after ILE treatment of 5 studied patients was 21.29 ± 10.28 %.

ILE improve epidermal barrier function when compared to lipid-free parenteral treatments. Results of the before/after study confirm this conclusion and the usefulness of ILE intake for preventing excessive TEWL. SC barrier function improvement could be a choice criterion between the different ILE generations, in particular in burn patients and premature neonates.