Evolution of lipid profile, liver function, and pattern of plasma fatty acids according to the type of lipid emulsion administered in parenteral nutrition in the early postoperative period after digestive surgery.
BACKGROUND
The metabolic effects of intravenous lipid emulsions (ILEs) used in parenteral nutrition (PN) depend on their fatty acid composition.


METHODS
Subjects in this prospective and randomized double-blind study were 28 adult patients post digestive surgery. PN was started after surgery and lasts for 5 days. Randomly, patients receive 1 of 4 different ILEs: medium-chain triglycerides/long-chain triglycerides (soybean oil; MCT/LCT), olive/soybean oil (oleic), long-chain triglycerides (soybean oil; LCT), and structured lipid. On days 0 and 6, serum liver function tests were analyzed for cholesterol, triglycerides, lipoproteins, and serum fatty acids.


RESULTS
No differences were found in the 4 groups according to their gender, age, body mass index, diagnosis, baseline white blood cell, C-reactive protein, glucose levels, and other study parameters. Differential significant changes were not observed in any of the hepatic function parameters or plasmatic lipid levels between the groups. A significant decrease was observed in cis monounsaturated fatty acids (MUFAs) and a significant increase in omega-6 polyunsaturated fatty acids (PUFAs) and omega-3 PUFA values in LCT and structured groups compared with MCT/LCT and oleic groups, and a tendency for a decrease in trans fatty acids in the oleic and structured groups was found.


CONCLUSIONS
All ILEs administered were safe and well tolerated. The changes in serum fatty acids reflected the pattern of fatty acids administered with different ILEs. The group receiving the olive oil emulsion achieved a fatty acid composition of serum lipids that could offer major therapeutic or biological advantages.
Nutritional Support Unit and Health Outcomes Research and Evaluation Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
C
C
Puiggròs
J
J
Sánchez
P
P
Chacón
P
P
Sabín
J
J
Roselló
R
R
Bou
M
M
Planas
D000368:Aged; D015992:Body Mass Index; D004311:Double-Blind Method; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage* / Q000032:analysis; D005227:Fatty Acids / Q000032:analysis / Q000097:blood*; D005260:Female; D041981:Gastrointestinal Tract / Q000601:surgery*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008099:Liver / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D019301:Oleic Acid / Q000008:administration & dosage; D000069463:Olive Oil; D010288:Parenteral Nutrition; D010938:Plant Oils; D011182:Postoperative Care; D011446:Prospective Studies; D013024:Soybean Oil; D014280:Triglycerides / Q000008:administration & dosage
D005217:Fat Emulsions, Intravenous; D005227:Fatty Acids; D008055:Lipids; D000069463:Olive Oil; D010938:Plant Oils; D014280:Triglycerides; D019301:Oleic Acid; D013024:Soybean Oil