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).
Lai
Hong-Shiee
HS
Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China. hslai@ha.mc.edu.tw
Lin
Wen-Hsi
WH
Wu
Hsiu-Chuan
HC
Chang
King-Jen
KJ
Chen
Wei-Jao
WJ
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