Document Detail


Replacement of long-chain triglyceride with medium-chain triglyceride/long-chain triglyceride lipid emulsion in patients receiving long-term parenteral nutrition: effects on essential fatty acid status and plasma vitamin K1 levels.
MedLine Citation:
PMID:  14763787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In long-term parenteral nutrition (LTPN) patients, the use of a 50:50 mixture of medium- and long-chain triglyceride emulsion (MCT/LCT) has been suggested to prevent or correct fatty liver infiltration. However, the use of MCT/LCT lipid emulsion results in a 50% reduction of essential fatty acids and vitamin K1 supply and could induce essential fatty acid and vitamin K1 deficiencies. This study evaluated the effect of a long-term infusion of MCT/LCT lipid emulsion on plasma fatty acid (FA) and vitamin K1 levels on LTPN patients. METHODS: In a prospective nonrandomized crossover study, we measured plasma phospholipid FA composition by gas chromatography and vitamin K1 levels by high-performance liquid chromatography in 11 LTPN patients before and after a 4-month replacement of the usual 20% LCT lipid emulsion (20% Lipoven; Fresenius-Kabi France, Sèvres, France) by a 20% MCT/LCT lipid emulsion (Medialipide B; Braun Medical, Boulogne, France). RESULTS: Patient received LTPN for 46 +/- 40 months; IV lipid emulsion was 827 +/- 336 mL/week. MCT/LCT lipid substitution did not change most of the essential plasma fatty acid concentrations and did not induce essential fatty acid deficiency. With both lipid emulsions, the triene/tetraene (20:3n-9/20:4n-6) ratio remained within the normal ranges. However, with MCT/LCT lipid emulsion, 22:4n-6 (LCT: 0.50 +/- 0.12; MCT/LCT: 0.63 +/- 0.11%) and 22:5n-6 (LCT: 0.32 +/- 0.11; MCT/LCT: 0.48 +/- 0.15%) increased significantly (p = .022 and 0.011, respectively). Plasma vitamin K1 levels decreased drastically with MCT/LCT lipid emulsion. CONCLUSIONS: An amount of 2.85 +/- 1.55 g x kg(-1) week(-1) of MCT/LCT lipid emulsion neither induced essential fatty acid deficiency nor improved the fatty acid disturbances usually observed in LTPN patients but did induce a drop in plasma vitamin K1 levels.
Authors:
Cécile Chambrier; Edith Bannier; Madeleine Lauverjat; Jocelyne Drai; Sylvie Bryssine; Paul Boulétreau
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  JPEN. Journal of parenteral and enteral nutrition     Volume:  28     ISSN:  0148-6071     ISO Abbreviation:  JPEN J Parenter Enteral Nutr     Publication Date:    2004 Jan-Feb
Date Detail:
Created Date:  2004-02-06     Completed Date:  2004-05-13     Revised Date:  2007-02-21    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  7-12     Citation Subset:  IM    
Affiliation:
Centre Agréé de Nutrition Parentérale à Domicile, Hôpital E. HERRIOT, 69437 Lyon, France. cecile.chambrier@chu-lyon.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cross-Over Studies
Fat Emulsions, Intravenous / chemistry*
Fatty Acids, Essential / blood*,  deficiency
Female
Humans
Male
Middle Aged
Nutritional Status*
Parenteral Nutrition / adverse effects*
Phospholipids / blood
Prospective Studies
Time Factors
Triglycerides / administration & dosage*,  chemistry
Vitamin K 1 / blood*
Chemical
Reg. No./Substance:
0/Fat Emulsions, Intravenous; 0/Fatty Acids, Essential; 0/Phospholipids; 0/Triglycerides; 84-80-0/Vitamin K 1

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