[Influence of Lipoplus fat emulsion on postoperative nutritional status and early inflammatory response in patients with gastrointestinal malignancies].
OBJECTIVE
To investigate the effect of Lipoplus on postoperative nutritional status and inflammatory response in patients with gastrointestinal malignancies.


METHODS
Sixty-four patients with gastrointestinal malignancies were randomized using random digit table to receive isonitrogenous, isocaloric total parenteral nutrition for 5 days including either Lipoplus or Lipofundin with 32 patients in each group. Blood samples were obtained before the surgery, postoperative days 1, 2, 3, and 6 to evaluate the nutritional status(prealbumin, retinol binding protein, and nitrogen balance) and inflammatory response [C-reaction protein(CRP), and leukotriene(LTB) 5, LTB4]. The incidence of postoperative systemic inflammatory response syndrome(SIRS), infection, postoperative complications, mortality, APACHEII score, length of hospital stay and other clinical indicators were recorded.


RESULTS
On postoperative day 1, prealbumin and retinol binding protein were significantly lower as compared to preoperative levels. These parameters increased significantly(P<0.05) on postoperative day 6 and the nitrogen balance was positive. On postoperative day 6, CRP was significantly lower in both groups as compared to postoperative day 3 (P<0.05), and the decrease was more prominent in Lipoplus than Lipofundin(P<0.05). There was a significant increase in LTB5/LTB4 as compared to postoperative day 1(P<0.05) in the Lipoplus group, however the increase was not statistically significant in the Lipofundin group(P>0.05). The incidence of postoperative infection was significantly lower in the Lipoplus group(3.1% vs. 6.3%, P<0.05), as was that of SIRS(9.4% vs. 15.6%, P<0.05). The APACHEII score was higher in the Lipoplus group but the difference was not statistically significant(3.6±2.0 vs. 3.3±2.1, P>0.05). The length of hospital stay was significantly shorter in Lipoplus group[(6.4±1.1) d vs. (8.2±1.3) d, P<0.05].


CONCLUSIONS
Lipoplus can improve the postoperative nutritional status and minimize the inflammatory response in patients with gastrointestinal malignancies.
Nanjing Medical University, Nanjing, China.
Cai-hua
CH
Zhang
Ning
N
Li
Xin-ying
XY
Wang
Guo-li
GL
Li
Chao-gang
CG
Fan
Jie-shou
JS
Li
D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage / Q000627:therapeutic use*; D005770:Gastrointestinal Neoplasms / Q000601:surgery; D006801:Humans; D007249:Inflammation / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010289:Parenteral Nutrition, Total / Q000379:methods; D011182:Postoperative Care
D005217:Fat Emulsions, Intravenous; D005395:Fish Oils