Does the type of parenteral lipids matter? A clinical hint in critical illness.

Details

Serval ID
serval:BIB_76150028274A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Does the type of parenteral lipids matter? A clinical hint in critical illness.
Journal
Clinical nutrition
Author(s)
Devaud J.C., Berger M.M., Pannatier A., Sadeghipour F., Voirol P.
ISSN
1532-1983 (Electronic)
ISSN-L
0261-5614
Publication state
Published
Issued date
04/2017
Peer-reviewed
Oui
Volume
36
Number
2
Pages
491-496
Language
english
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Abstract
An altered lipid profile is common among intensive care unit (ICU) patients, but evidence regarding the impact of different fatty acid (FA) emulsions administered to patients requiring parenteral nutrition (PN) is scarce. This study aimed to compare the plasma triglycerides (TG) response to two types of commercial lipid emulsions: a structured mixture of long- and medium-chain triglycerides (LCT/MCT) or LCTs with n-9 FA (LCT+) in ICU patients.
In this retrospective observational study conducted in a multidisciplinary ICU: two groups were defined by the type of emulsion used. Inclusion criteria were: consecutive patients on PN staying ≥4 days with one TG determination before commencing PN and at least one during PN. Recorded variables included energy intake, amount and type of nutritional lipids, propofol dose, glucose and protein intake, laboratory parameters, and all drugs received. Hypertriglyceridemia (hyperTG) was defined as TG >2 mmol/L.
The dynamic impact of the emulsion was analyzed in 187/757 patients completing the inclusion criteria (112 LCT/MCT and 75 LCT+). The demographic variables, severity indices, diagnostic categories, and outcomes did not differ between the two groups. Seventy-seven patients (41%) presented hyperTG. Both groups received similar daily energy (1604 versus 1511 kcal/day), lipids (60 versus 61 g/day), and glucose intake (233 versus 197 g/day). There was no increase of TG concentration in those receiving the LCT/MCT emulsion compared to those receiving the LCT+ emulsion (0 and 0.2 mmol/L, respectively, p < 0.05).
LCT/MCT emulsions are associated with a less pronounced increase of plasma TG levels than LCT+ emulsions.

Keywords
Aged, Alanine Transaminase/blood, Aspartate Aminotransferases/blood, Critical Illness/therapy, Dietary Fats/administration & dosage, Dietary Proteins/administration & dosage, Fat Emulsions, Intravenous/administration & dosage, Fat Emulsions, Intravenous/adverse effects, Fatty Acids, Monounsaturated/administration & dosage, Fatty Acids, Monounsaturated/blood, Female, Humans, Hypertriglyceridemia/epidemiology, Hypertriglyceridemia/etiology, Incidence, Intensive Care Units, Male, Middle Aged, Nutritional Requirements, Parenteral Nutrition/adverse effects, Retrospective Studies, Triglycerides/blood, Hypertriglyceridemia, ICU, Lipid metabolism, Nutrition, Propofol, Sedation
Pubmed
Web of science
Create date
16/02/2016 17:32
Last modification date
17/09/2020 8:24
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