title: Structured lipid emulsion as nutritional therapy for the elderly patients with severe sepsis.
abstract: BACKGROUND
  The nutritional support is one of the important therapeutic strategies for the elderly patients with severe sepsis, but there is controversial in choosing a parenteral nutrition formulation. This study was designed to compare the therapeutic effects of structured lipid emulsion, physically mixed medium, and long-chain fat emulsion in the treatment of severe sepsis in elderly patients.
  
  
  METHODS
  A total number of 64 elder patients with severe sepsis were enrolled in the study. After a week of enteral nutritional support, the patients were randomly divided into research (structured lipid emulsion as parenteral alimentation) and control groups (physically mixed medium and long-chain fat emulsion as parenteral alimentation). The alterations of plasma albumin, lipid metabolism, and blood glucose level were recorded after parenteral alimentation and were compared between the two groups.
  
  
  RESULTS
  The plasma levels of albumin, prealbumin, cholesterol, and triglyceride were decreased in all the patients after one week of enteral nutritional support treatment (t = 7.78, P = 0.000; t = 10.21, P = 0.000; t = 7.99, P = 0.000; and t = 10.99, P = 0.000). Further parenteral alimentation with different lipid emulsions had significant effects on the serum prealbumin and albumin (t = 3.316, P = 0.002; t = 3.200, P = 0.002), whilst had no effects on the blood glucose and triglyceride level (t = 7.78, P = 0.000; t = 4.228, P = 0.000). In addition, the two groups had a significantly different Apache II score, ventilator time, and hospital stay time (t = -2.213, P = 0.031; t = 2.317, P = 0.024; t = 2.514, P = 0.015).
  
  
  CONCLUSIONS
  The structured lipid emulsion was safe as parenteral nutrition for elderly patients with severe sepsis. It was demonstrated to be superior to the physically mixed medium and long-chain fat emulsion with respect to the protein synthesis and prognosis.
authors.affiliation: Department of Intensive Care Unit, Zhejiang Hospital, Hangzhou, Zhejiang 310013, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Chen
authors.forename: Jing
authors.initials: J
authors.lastname: Yan
authors.forename: Guo-Long
authors.initials: GL
authors.lastname: Cai
authors.forename: Qiang-Hong
authors.initials: QH
authors.lastname: Xu
authors.forename: Shi-Jin
authors.initials: SJ
authors.lastname: Gong
authors.forename: Hai-Wen
authors.initials: HW
authors.lastname: Dai
authors.forename: Yi-Hua
authors.initials: YH
authors.lastname: Yu
authors.forename: Li
authors.initials: L
authors.lastname: Li
mesh_terms: D000368:Aged; D004655:Emulsions; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D018805:Sepsis / Q000097:blood / Q000188:drug therapy*; D012709:Serum Albumin / Q000032:analysis; D014280:Triglycerides / Q000097:blood
chemical_list: D004655:Emulsions; D005217:Fat Emulsions, Intravenous; D012709:Serum Albumin; D014280:Triglycerides