Novel triglycerides for special medical purposes.
The clinical use of intravenous lipid emulsions have been routine for over 25 years. For most of that time period the use of the vegetable oils, soybean and safflower, were the exclusive lipid source for these emulsions. Recently intravenous medium-chain triglycerides have been commercially available. This review will discuss several important new research developments coming from the laboratory which should prove to enhance the nutritional effectiveness as well as minimize the adverse effects of lipid emulsions. The use of medium-chain triglycerides either enterally or parenterally has shown them to be superior energy sources when compared to long-chain triglycerides. Under experimental conditions of burn injury, their support of certain aspects of protein metabolism is superior to that of the current emulsions. This may be due to their rapid and preferential oxidation and poor storage into adipose tissue, and increased thermogenesis which has been observed from either enteral or parenteral administration in humans. This increased metabolic rate is not accompanied by an increase in temperature. Lipid emulsions have been described as having many different effects on variable aspects of the immunologic system. Some of these could be considered to be beneficial or without harm, and others are considered potentially deleterious. We have focused on the effects of parenteral lipid emulsions, in animals as well as in humans, on the function of the reticuloendothelial system.(ABSTRACT TRUNCATED AT 250 WORDS)
Mascioli
E A
EA
Department of Medicine, Harvard Medical School, Boston, Massachusetts.
Babayan
V K
VK
Bistrian
B R
BR
Blackburn
G L
GL
D000818:Animals; D004734:Energy Metabolism; D005217:Fat Emulsions, Intravenous; D006801:Humans; D013312:Stress, Physiological / Q000628:therapy*; D014280:Triglycerides / Q000627:therapeutic use*
D005217:Fat Emulsions, Intravenous; D014280:Triglycerides