Effects of a medium-chain triacylglycerol/long-chain triacylglycerol fat emulsion containing a reduced ratio of phospholipid to triacylglycerol in pediatric surgical patients

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Los Angeles County, Calif.), 2005-07, Vol.21 (7), p.825-830
• Main Authors: Lai, Hong-Shiee, Lin, Wen-Hsi, Wu, Hsiu-Chuan, Chang, King-Jen, Chen, Wei-Jao
• Format: Article
• Language: English
• Subjects: Amino acids; Biological and medical sciences; Child; Child, Preschool; Cholesterol - blood; Dose-Response Relationship, Drug; Emulsions; Esophagus; Fat Emulsions, Intravenous - chemistry; Fatty acids; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastrointestinal diseases; Humans; Lipids; Lipoprotein; Lipoproteins; Lipoproteins, HDL - blood; Lipoproteins, LDL - blood; Long-chain triacylglycerol; Male; Medium-chain triacylglycerol; Nutritional Status; Oxidation; Parenteral nutrition; Parenteral Nutrition, Total - methods; Parenteral Nutrition, Total - standards; Phospholipid/triacylglycerol ratio; Phospholipids - administration & dosage; Phospholipids - blood; Phospholipids - metabolism; Postoperative Care - methods; Triglycerides - administration & dosage; Triglycerides - blood; Triglycerides - chemistry; Triglycerides - metabolism; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0899-9007; 1873-1244
• DOI: 10.1016/j.nut.2004.11.017

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. 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. 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). 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).