[Comparative study of long-term parenteral nutrition with medium-chain and long-chain triglycerides in post-aggression metabolism].
OBJECTIVE
To determine the effect of a pure glucose and of different glucose/fat regimens as nonprotein energy source on substrate metabolism, nitrogen balance, lipoprotein pattern and liver enzymes. Long-chain and mixed long-/medium-chain triglyceride emulsions as 10 and 20% solutions were infused.


METHODS
Prospective randomized study.


METHODS
General ward of a university hospital.


METHODS
29 patients in five groups after colorectal surgery.


METHODS
According to Harris-Benedict an amount of 150% of the calculated daily calorie intake was infused. Besides nitrogen balance and routine laboratory tests the lipoprotein pattern was examined.


RESULTS
No difference was observed in protein balance, while a pathological rise of liver enzymes was mainly seen with glucose 20% and long-chain fat emulsions in a concentration of 10%. Physiological lipoprotein balance could only be achieved with a 20% solution of long-chain and medium-chain emulsions.


CONCLUSIONS
The results demonstrate a fast metabolism of the MCT/LCT 20% solution with physiological lipoprotein pattern and no change in liver enzymes. High-dose glucose infusions and long-chain fat emulsions may cause a fatty degeneration of the liver, and 10% MCT/LCT emulsions may cause a rise of phospholipids and a generation of lipoprotein X.
Herrmann
A
A
Chirugische Klinik und Poliklinik, Ludwig-Maximilians-Universität München, BRD.
Jauch
K W
KW
Hailer
S
S
Wolfram
G
G
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001798:Blood Proteins / Q000378:metabolism; D004734:Energy Metabolism / Q000502:physiology*; D005217:Fat Emulsions, Intravenous; D005227:Fatty Acids / Q000097:blood; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000201:enzymology / Q000601:surgery*; D008074:Lipoproteins / Q000097:blood; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D014280:Triglycerides / Q000008:administration & dosage* / Q000097:blood
D001786:Blood Glucose; D001798:Blood Proteins; D005217:Fat Emulsions, Intravenous; D005227:Fatty Acids; D008074:Lipoproteins; D014280:Triglycerides; D001219:Aspartate Aminotransferases; D000469:Alkaline Phosphatase
Vergleichende Studie zur langfristigen parenteralen Ernährung mit mittelkettigen und langkettigen Triglyzeriden im Postaggressionsstoffwechsel.