I am not aware of guidelines specific to fungemia. The best we might do is look at the data that is available on the use of IV lipids in critically ill patients. This is relatively weak evidence but is a recommendation that can be found here:
As you will note it comes with our weakest recommendation that a strategy that reduces the load of omega-6 fatty acids/soy bean oils should be considered.
On the practical side I would usually recommend not using soy based IV lipid emulsions in the first week of illness associated with bacteremia/fungemia/sepsis and then introduce lipids. We are then more commonly using another source of lipids rather than Intralipid but if that is not available would start with low dose Intralipid such as thrice weekly.
I hope this helps.
John W. Drover, MD, FRCSC, FACS, CCPE
Departments of Critical Care Medicine and Surgery
Critical Care Physician Lead, South East LHIN
Kingston General Hospital
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