Metabolic effects in neonates receiving intravenous medium-chain triglycerides

• Published in: Acta Paediatrica 2002-02, Vol.91 (2), p.188-197
• Main Authors: Angsten, G, Boberg, M, Cederblad, G, Meurling, S, Stiernström, H
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Carnitine - analogs & derivatives; Carnitine - analysis; Double-Blind Method; Emergency and intensive care: neonates and children. Prematurity. Sudden death; Emergency and intensive postoperative care (general aspects). Pathophysiology of surgery; Fat Emulsions, Intravenous - chemistry; Fat Emulsions, Intravenous - therapeutic use; Fatty Acids, Nonesterified - analysis; Female; Humans; Infant, Newborn; Intensive care medicine; Male; Medical sciences; MEDICIN; MEDICINE; Medium-chain triglycerides; muscle and plasma carnitine; Muscle, Skeletal - chemistry; neonates; Parenteral Nutrition, Total; respiratory quotient; Triglycerides - administration & dosage; Triglycerides - blood
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/j.1651-2227.2002.tb01694.x

The effects of two lipid emulsions, one with 50% each of medium‐chain and long‐chain triglycerides, and a long‐chain triglycerides lipid emulsion as a control, were evaluated for lipid and carnitine metabolism and respiratory quotient when given to neonates after major surgery during a short period of total parenteral nutrition. Each group included 10 neonates, and all tolerated the total parenteral nutrition well. The relative contents of linoleic acid and α‐linolenic acid increased in all lipid esters in plasma and adipose tissue in both groups, indicating that the content of these fatty acids is sufficient even in the medium‐chain triglycerides emulsion. The serum concentration of ketones was within normal limits. Free fatty acids in plasma did not increase in either group. The total plasma carnitine concentration decreased in both groups but the distribution of free carnitine and acylcarnitine did not change. The total muscle carnitine did not change significantly but the ratio of acylcarnitine to free carnitine tended to increase in muscle in the treatment group, probably an effect of the medium‐chain triglyceride supplementation. Conclusions: The two groups displayed the same fatty acid pattern in plasma and adipose tissue and the same respiratory quotient during the treatment period. Regarding carnitine status, essentially the same changes were seen in the two groups. However, discrete changes were seen in muscle tissue in the treatment group.