[The effect of fatty emulsions with distinct triglyceride compositions on the lipid metabolism of the septic patient].
OBJECTIVE
To assess the effects on the intravascular lipid mechanism of fatty emulsions with an identical lipid concentration and a different triglyceride composition administered as part of the total parenteral nutrition (TPN) in septicemic patients hospitalized in the intensive care unit (ICU). One emulsion will be made up of long chain triglycerides, LCT (20% Intralipid) (group I) and the other will be made up by a mixture of medium- and long-chain triglycerides, MCT/LCT (1:1) (20% Lipofundina) (group II). AREA: Vall d'Hebrón General University Hospital. Intensive care unit, Biochemistry laboratory, nutritional support unit, and Department of Pharmacy.


METHODS
12 septicemic patients who required TPN were studied, and these patients were randomly given one of the two lipid emulsions for a five day period. Prior to initiating the TPN and before ending it, blood samples were drawn for the analysis of the lipoprotein components VLDL, LDL, and HDL isolated by ultracentrifugation, and the basic lipid and nutritional parameters.


RESULTS
The baseline statistical analysis shows that even though both groups are not comparable, the composition of the VLDL, LDL, and HDL lipoproteins differs from the reference values. After five days of TPN, the metabolic behavior of the groups is different, in group I the concentrations of reactive C protein (RCP) decreased as did the HDL phospholipids, while group II presented an increase in the plasma triglyceride levels, the VLDL cholesterol, the LDL triglycerides, and the HDL proteins.


CONCLUSIONS
Septicemic patients present in altered lipoprotein pattern that tends to normalize after 5 days of lipid emulsions administration.
Chacón Castro
M P
MP
Servicio de Bioquímica, Hospital General Universitario Vall d'Hebrón, Barcelona, España.
Jiménez Sesé
G
G
Salvadó Salvát
J
J
Sabín Urquía
P
P
Pascual Mostaza
C
C
Planas Vilà
M
M
D000328:Adult; D004338:Drug Combinations; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood; D010289:Parenteral Nutrition, Total / Q000379:methods / Q000706:statistics & numerical data; D010743:Phospholipids / Q000627:therapeutic use*; D018805:Sepsis / Q000097:blood / Q000628:therapy*; D013012:Sorbitol / Q000627:therapeutic use*
D004338:Drug Combinations; D005217:Fat Emulsions, Intravenous; D008055:Lipids; D008074:Lipoproteins; D010743:Phospholipids; C008288:Lipofundin; D013012:Sorbitol