title: Effect of Critical Illness on Triglyceride Absorption.
abstract: BACKGROUND
  Adequate nutrition support for critically ill patients optimizes outcome, and enteral feeding is the preferred route of nutrition. Small intestinal glucose absorption is frequently impaired in critical illness. Despite lipid being a major constituent of liquid nutrient administered, there is little information about lipid absorption during critical illness.
  
  
  OBJECTIVE
  To determine small intestinal lipid, as well as glucose, absorption in critical illness compared with health.
  
  
  METHODS
  Twenty-nine mechanically ventilated critically ill patients and 16 healthy volunteers were studied. Liquid nutrient (60 mL, 1 kcal/mL), containing 200 µL (13)C-triolein and 3 g 3-O-methyl-glucose (3-OMG), was infused directly into the duodenum at a rate of 2 kcal/min. Exhaled (13)CO2 and serum 3-OMG concentrations were measured at timed intervals over 360 minutes. Lipid absorption was measured as the cumulative percentage dose (cPDR) of (13)CO2 recovered at 360 minutes. Glucose absorption was measured as the area under the 3-OMG concentration curve. Data are median (range) and analyzed using the Mann-Whitney U and Pearson correlation tests.
  
  
  RESULTS
  Lipid absorption was markedly less in the critically ill (cPDR(13)CO2: patients, 22.6% [0%-100%] vs healthy participants, 40.7% [5.3%-84.7%]; P = .018). While glucose absorption was less at 60 minutes in the critically ill (3-OMG60: 13.2 [3.5-29.5] vs 21.1 [9.3-31.9] mmol/L·min; P = .003), this was not apparent at 360 minutes (3-OMG360: 92.7 [54.5-147.9] vs 107.9 [64.0-168.7] mmol/L·min; P = .126). There was no relationship between lipid and glucose absorption.
  
  
  CONCLUSIONS
  Small intestinal absorption of lipid is diminished during critical illness.
authors: Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, Australia yasmineaa@hotmail.com.
authors: Yasmine
authors: Y
authors: Ali Abdelhamid
authors: Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, Australia.
authors: Caroline E
authors: CE
authors: Cousins
authors: Discipline of Acute Care Medicine, University of Adelaide, Adelaide, Australia.
authors: Jennifer A
authors: JA
authors: Sim
authors: Department of Nuclear Medicine, Royal Adelaide Hospital, Adelaide, Australia.
authors: Max S
authors: MS
authors: Bellon
authors: Discipline of Medicine, University of Adelaide, Adelaide, Australia.
authors: Nam Q
authors: NQ
authors: Nguyen
authors: Discipline of Medicine, University of Adelaide, Adelaide, Australia.
authors: Michael
authors: M
authors: Horowitz
authors: Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, Australia Discipline of Acute Care Medicine, University of Adelaide, Adelaide, Australia.
authors: Marianne J
authors: MJ
authors: Chapman
authors: Department of Critical Care Services, Royal Adelaide Hospital, Adelaide, Australia Discipline of Acute Care Medicine, University of Adelaide, Adelaide, Australia.
authors: Adam M
authors: AM
authors: Deane
mesh_terms: D000328:Adult; D000368:Aged; D016638:Critical Illness / Q000628:therapy*; D004750:Enteral Nutrition; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007408:Intestinal Absorption; D007421:Intestine, Small / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D014280:Triglycerides / Q000378:metabolism*; D055815:Young Adult
chemical_list: D014280:Triglycerides; D005947:Glucose
keywords: critical care; enteral nutrition; lipids; nutrition; research and diseases