[The problem of dosage and importance of fats in parenteral feeding].
Using human volunteers the metabolic effects of continuous infusions of fat emulsions (Intralipid and Lipofundin S) without and with addition of carbohydrates and amino acids were investigated. A steady state for triglyceride concentration was attained even at an infusion rate of 0.25 gm/kg BW for Lipofundin S. This fat emulsion was utilized during parenteral administration of 0.1 gm/kg BW almost without an increase in triglyceride concentration. In the case of parenteral administration of Intralipid, however, we did not find indications for the existence of a steady state for serum triglyceride concentration. Without the addition of carbohydrates the parenteral application of fat emulsions causes hyperlipacidemia and ketosis even in metabolically healthy volunteers. These metabolic effects are suppressed by the simultaneous administration of fructose or glucose. The concentration of inorganic phosphate is elevated merely during the highly dosed infusions of Lipofundin S and not by Intralipid. Liver functions were not altered even by highly dosed intravenous fat. According to the results of these investigations in human volunteers Intralipid is eliminated considerably slower than Lipofundin S. There should be qualitative differences also. Lipofundin S is obviously to a greater extent metabolized by the physiological intravasal fat metabolizing system. The small elimination capacity for Intralipid, however, demands caution in the uncontrolled application of this fat emulsion to severely ill patients. Even the better metabolized Lipofundin S should be infused principally with the addition of carbohydrates. By taking these precautions the undesirable metabolic effects of intravenous fat (i.e. lipacidemia and ketosis) are prevented.
D000596:Amino Acids; D001786:Blood Glucose / Q000032:analysis; D004040:Dietary Carbohydrates; D004041:Dietary Fats / Q000378:metabolism*; D004798:Enzymes / Q000097:blood; D005227:Fatty Acids / Q000097:blood; D006801:Humans; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D007657:Ketone Bodies / Q000097:blood; D007662:Ketosis / Q000209:etiology; D010288:Parenteral Nutrition; D010710:Phosphates / Q000097:blood; D014280:Triglycerides / Q000097:blood
D000596:Amino Acids; D001786:Blood Glucose; D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004798:Enzymes; D005227:Fatty Acids; D007328:Insulin; D007657:Ketone Bodies; D010710:Phosphates; D014280:Triglycerides
Untersuchungen zur Frage der Dosierung und zur Bedeutung von Fett bei parenteraler Ernährung.