[Lipid infusion in multiple trauma intensive care patients in the early phase of treatment].
OBJECTIVE
To study the metabolic effects of a high-dose fat infusion application in the early phase of total parenteral nutrition (TPN) after major trauma.


METHODS
Prospective study in male patients after major trauma.


METHODS
Intensive care unit of the University Clinic.


METHODS
21 male, mechanically ventilated patients after major trauma.


METHODS
Infusion of Elolipid 20% (Fa. Leopold, Graz, Austria), starting on the 3rd day after ICU admission (0.075 g/kg body weight/h) in 8 h. The dose was increased on the 5th day (0.125 g/kg BW/h) and on the 7th day (0.15 g/kg BW/h).


RESULTS
There was a pathologic rise in serum triglycerides on days 3, 5 and 7 during the infusion period. A serious diabetic metabolic state was shown on the 3rd day. No significant changes in urea production rate could be demonstrated after the high-dose fat infusion.


CONCLUSIONS
The reason for the decreased fat elimination in patients after major trauma after high-dose fat infusion (8 h) remains unclear (fat clearance or fat oxidation failure). Therefore the fat infusion should be started after normalization of the blood glucose level. Thus the fat infusion should be given continuously over 24 h to avoid serious metabolic complications.
Gottardis
M
M
Klinik für Anästhesie, Intensivmedizin, Universität Innsbruck, Graz, Osterreich.
Hackl
J M
JM
Gruber
E
E
Wieser
C
C
Adelsmayr
E
E
Seyr
M
M
Zadravec
M
M
Pfeiffer
K P
KP
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001806:Blood Urea Nitrogen; D002784:Cholesterol / Q000097:blood; D003422:Critical Care; D002149:Energy Intake / Q000502:physiology; D005217:Fat Emulsions, Intravenous; D005230:Fatty Acids, Nonesterified / Q000097:blood; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood / Q000628:therapy*; D010289:Parenteral Nutrition, Total; D014280:Triglycerides / Q000097:blood*
D001786:Blood Glucose; D005217:Fat Emulsions, Intravenous; D005230:Fatty Acids, Nonesterified; D014280:Triglycerides; D002784:Cholesterol
Fettinfusion bei polytraumatisierten Intensivpatienten in der Frühphase der Behandlung.