A Study of Intravenous Emulsion Compatibility: Effects of Dextrose, Amino Acids, and Selected Electrolytes

Abstract
Microscopic and electronic counting procedures as well as visual observations for creaming and flocculation were employed to quantitatively and qualitatively measure the effects of dextrose, amino acids, and various mono- and di-valent cations on the globule size distribution of the soybean oil emulsion 10%, Intralipid®. A linear regression analysis was demonstrated to successfully profile much of the stability data. Results indicated that divalent cations caused flocculation in the emulsion's internal phase immediately upon or shortly after the addition of their salts. The rate and extent of flocculation intensified with increasing ionic concentration. Amino acids, apparently acting at the oil/water interface, delayed divalent cation-induced flocculation; however, they did not prevent emulsion stability loss. The addition of dextrose 5% or 12.5% brought about a reduction of emulsion pH and significant globule coalescence 72 hours after admixture. Monovalent cations (i.e., Na+, K+) induced a progressive loss of emulsion stability over the 72-hour course of the experiments, the effect a function of ionic concentration. From the data, a model has been generated to predict significant changes ( p < 0.05) in Intralipid's® globule size distribution upon addition of solute and exposure to room temperature. Further recommendations of solute admixture with the intravenous emulsion are also included.