Hi @calypso75 - the way it was explained to me by the nurse was that intralipids (or TPN for patients with poor nutrition!) can be extremely irritating to veins. Particularly when adminstered through a peripheral line (which is the technical distinction for a short cannula in your arm). Normally if we give this to malnourished people in hospital, we put in a PICC line so it is fed into a much bigger vein (subclavian vein or supra vena cava).
So to make sure there's not too much irritation they infuse it with normal saline. They start off slowly at 100ml/hr and if everything is fine after 15 mins with the cannula, then they will increase the rate to 150ml/hr. Alongside this, through a 3-way tap, is the normal saline running at a constant 100ml/hr.
So all up I had 500ml of 20% intralipid and probably only 450ml of normal saline. It took about 3.5hrs of infusion time.
As to the total dose, well, I suspect that Wazza was hammering me because my numbers are well over the 75 centile (prob closer to the 98 centile). Don't know what I've been doing, but I am clearly a natural killer!
Whether they give smaller doses for lesser NK levels, I don't know. I'll ask Wazza next time I see him.
My advice is to go with whatever protocol the FS you feel most comfortable with says. It's not main****** medicine and immunology is a very crude field, let alone reproductive immunology, so the evidence isn't robust. Though just because there's a lack of evidence, doesn't mean it doesn't work.
It just frustrates me how little formal research is being done on all of this. If I ran QFG....!