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[Rachel Phillips]

First, you have to make sure it was an allergy due to that lipid, usually hypersensitivity to any of TPN components is rare. Once confirmed, so any lipid containing LCT oil will not be applicable for use (including SMOF), unless you want to try any other lipid to confirm the allergy itself!

Also Omegaven (which is 100% refined fish oil) should not be used alone, it has to be mixed as well with LCT oil for use. Also, it has no linoleic acid and alpha linolinec acids (essential fatty acids), so can’t substitute Intralipid.

So, I suggest (again, after you make sure allergy is due to lipid emulsion) that you can rub the patient’s skin by safflower oil (or any oil rich in essential fatty acids), here you don’t give calories, but you only avoid Essential Fatty Acid Deficiency Syndrome.

I hope it helps.