Effects of a medium-chain triacylglycerol/long-chain triacylglycerol fat emulsion containing a reduced ratio of phospholipid to triacylglycerol in pediatric surgical patients.
OBJECTIVE
Medium-chain triacylglycerol (MCT) has been shown to provide better nutritional support than long-chain triacylglycerol (LCT). We compared the efficacy of MCT/LCT fat emulsions containing a usual (0.12) or a decreased (0.06) ratio of phospholipid to triacylglycerol (PL:TG) in pediatric patients under surgical stress.


METHODS
Three patient groups (n=10 in each) received equivalent amounts of glucose (12 g.kg(-1).d(-1)) and amino acids (2 g.kg(-1).d(-1)), but group A received a 10% MCT fat emulsion (PL:TG 0.06), group B received a 20% MCT fat emulsion (PL:TG 0.06), and group C received a 10% MCT/LCT fat emulsion (PL:TG 0.12) in amounts of 1.5 g.kg(-1).d(-1) in a randomized study. Total parenteral nutrition was given for 7 d. Blood samples were collected before total parenteral nutrition administration and on days 4 and 7 for determination of various biochemical indexes.


RESULTS
Serum phospholipid concentrations were significantly higher in group C than in group A or B on days 4 and 7 (P<0.05). Serum triacylglycerol and cholesterol concentrations and the very-low-density lipoprotein percentage were also significantly higher in group C than in group A or B on days 4 and 7 (P<0.05). The high-density lipoprotein percentage was significantly higher in group B on days 4 and 7 (P<0.05).


CONCLUSIONS
In pediatric patients under surgical stress, a total parenteral nutrition regimen containing an MCT/LCT fat emulsion with a decreased PL:TG ratio (0.06) is likely to result in partly better lipid and lipoprotein metabolism than an emulsion containing the usual ratio (0.12).
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China. hslai@ha.mc.edu.tw
Hong-Shiee
HS
Lai
Wen-Hsi
WH
Lin
Hsiu-Chuan
HC
Wu
King-Jen
KJ
Chang
Wei-Jao
WJ
Chen
D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005217:Fat Emulsions, Intravenous / Q000737:chemistry*; D005260:Female; D006801:Humans; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D009752:Nutritional Status; D010289:Parenteral Nutrition, Total / Q000379:methods / Q000592:standards*; D010743:Phospholipids / Q000008:administration & dosage* / Q000097:blood / Q000378:metabolism; D011182:Postoperative Care / Q000379:methods*; D014280:Triglycerides / Q000008:administration & dosage* / Q000097:blood / Q000737:chemistry / Q000378:metabolism
D005217:Fat Emulsions, Intravenous; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D010743:Phospholipids; D014280:Triglycerides; D002784:Cholesterol