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Evolution of Lipid Profile, Liver Function, and Pattern of Plasma Fatty Acids According to the Type of Lipid Emulsion Administered in Parenteral Nutrition in the Early Postoperative Period After Digestive Surgery

From the ¹ Nutritional Support Unit and² Health Outcomes Research and Evaluation Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain; and³ Cátedra de Nutrición y Bromatología, Facultad de Farmacia, Universidad de Barcelona, Barcelona, Spain.

Address correspondence to: M. Planas, MD, Nutritional Support Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain; e-mail: mplanas96{at}gmail.com

Background: The metabolic effects of intravenous lipid emulsions (ILEs) used in parenteral nutrition (PN) depend on their fatty acid composition. Methods: Subjects in this prospective and randomized double-blind study were 28 adult patients post digestive surgery. PN was started after surgery and lasts for 5 days. Randomly, patients receive 1 of 4 different ILEs: medium-chain triglycerides/long-chain triglycerides (soybean oil; MCT/LCT), olive/soybean oil (oleic), long-chain triglycerides (soybean oil; LCT), and structured lipid. On days 0 and 6, serum liver function tests were analyzed for cholesterol, triglycerides, lipoproteins, and serum fatty acids. Results: No differences were found in the 4 groups according to their gender, age, body mass index, diagnosis, baseline white blood cell, C-reactive protein, glucose levels, and other study parameters. Differential significant changes were not observed in any of the hepatic function parameters or plasmatic lipid levels between the groups. A significant decrease was observed in cis monounsaturated fatty acids (MUFAs) and a significant increase in -6 polyunsaturated fatty acids (PUFAs) and -3 PUFA values in LCT and structured groups compared with MCT/LCT and oleic groups, and a tendency for a decrease in trans fatty acids in the oleic and structured groups was found. Conclusions: All ILEs administered were safe and well tolerated. The changes in serum fatty acids reflected the pattern of fatty acids administered with different ILEs. The group receiving the olive oil emulsion achieved a fatty acid composition of serum lipids that could offer major therapeutic or biological advantages.

Key Words: lipid emulsions • parenteral nutrition • lipid profile • plasma fatty acids • liver function

This version was published on September 1, 2009

Journal of Parenteral and Enteral Nutrition, Vol. 33, No. 5, 501-512 (2009)
DOI: 10.1177/0148607109333001


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