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**medium-chain triglycerides + olive oil + soybean oil + fish oil** is a four-oil intravenous lipid emulsion for parenteral nutrition marketed as **SMOFlipid** and developed by Fresenius Kabi. It combines soybean oil, medium-chain triglycerides, olive oil, and fish oil to provide calories, essential fatty acids, and omega-3 fatty acids in patients who cannot receive adequate oral or enteral nutrition, including adults, children, and term and preterm neonates. Mechanistically, it acts as a nutritional replacement therapy rather than a receptor-targeted pharmacologic agent, delivering triglycerides and essential fatty acids that are metabolized for energy, membrane synthesis, and correction or prevention of essential fatty acid deficiency; compared with pure soybean-oil emulsions, it provides a lower omega-6 burden and includes fish-oil-derived omega-3 fatty acids such as EPA and DHA.
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