The metabolic response to intravenous medium-chain triglycerides in infants after surgery

Donnell, S.C.; Eaton, Simon; Pierro, Agostino

doi:10.1067/mpd.2002.128889

Cited by 33 publications

(17 citation statements)

References 31 publications

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“…Both lipid emulsions were well tolerated in the infants that we followed, similar to observations made in previous studies (23). Compared with the control group, the MCT/ LCT group tended toward a lower body weight at baseline (NS), showed a greater weight loss, and regained birth weight later, although the extent of parenteral nutrition and caloric intake was comparable in the two groups.…”

Section: Discussionsupporting

confidence: 66%

Metabolic effects of intravenous LCT or MCT/LCT lipid emulsions in preterm infants

Lehner

Demmelmair

Röschinger

et al. 2006

Journal of Lipid Research

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Most lipid emulsions for parenteral feeding of premature infants are based on long-chain triacylglycerols (LCTs), but inclusion of medium-chain triacylglycerols (MCTs) might provide a more readily oxidizable energy source. The influence of these emulsions on fatty acid composition and metabolism was studied in 12 premature neonates, who were randomly assigned to an LCT emulsion (control) or an emulsion with a mixture of MCT and LCT (1:1). On study day 7, all infants received [

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Section: Discussionsupporting

confidence: 66%

Metabolic effects of intravenous LCT or MCT/LCT lipid emulsions in preterm infants

Lehner

Demmelmair

Röschinger

et al. 2006

Journal of Lipid Research

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“…In children undergoing gastrointestinal surgery, PN with MCT/ SOY was associated with rapid oxidation of fats for energy and more protein sparing, compared with a regimen containing exclusively SOY IVLE [12,13]. In addition, 14 days after surgery the MCT/SOY regimen was associated with lower serum levels of alanine aminotransferase (ALT), total and conjugated bilirubin [12].…”

Section: Introductionmentioning

confidence: 99%

Parenteral nutrition-associated cholestasis and triglyceridemia in surgical term and near-term neonates: A pilot randomized controlled trial of two mixed intravenous lipid emulsions

Pereira‐da‐Silva

Nóbrega

Rosa

et al. 2017

Clinical Nutrition ESPEN

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s u m m a r yBackground: Cholestasis is a common complication in infants receiving prolonged parenteral nutrition (PN). We studied the effects of two intravenous lipid emulsions composed with either 30% soybean oil, 30% medium-chain triglycerides (MCT), 25% olive oil, and 15% fish oil (SMOF) or with 50% MCT and 50% soybean oil n-6 (MCT/SOY) on the incidence of cholestasis in surgical term and near-term neonates. Methods: A single-center, double-blinded, randomized controlled trial compared the incidence of cholestasis using either SMOF or MCT/SOY in neonates born at gestational age !34 weeks undergoing major surgery. The primary outcome was the incidence of conjugated serum bilirubin >1 mg/dL. Other liver enzymes were assessed as secondary outcomes. A post-hoc analysis assessed serum triglycerides levels. Odds ratios were estimated by mixed-effects regression models. Results: Enrollment was prematurely interrupted because the MCT/SOY became unavailable, thus 49 infants (SMOF 22, MCT/SOY 27) completed the study. The exposure (time on PN, cumulative dose of lipids) was similar in both groups. Similar cumulative incidence rates were found for elevated conjugated bilirubinemia and other liver enzymes. Hypertriglyceridemia >250 mg/dL (12/49) was more frequent in MCT/SOY (37.0%, 95% CI 21.53e55.77) than in SMOF (9.1%, 95% CI 2.53e27.81, p ¼ 0.024). Triglyceridemia at the first assessment (median 8 postnatal days) was significantly higher with MCT/SOY than with SMOF (181 vs. 134 mg/dL, p ¼ 0.006). Over the whole study period, mean triglyceride concentration was 36.5 mg/dL higher with MCT/SOY compared with SMOF (p ¼ 0.013). Conclusion: Both emulsions had similar effects on the incidence of cholestasis and markers of liver integrity, but MCT/SOY induced higher serum triglyceride concentrations. Trial registration: ClinicalTrials.gov, NCT02633384

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“…MCTs more easily access mitochondria, where FA catabolism occurs, and are more efficiently oxidized to ATP than LCTs (65,66). Fat utilization in PN-dependent patients is improved in those who are administered MCT-containing lipids compared with those administered solely LCT-containing lipids (67,68).…”

Section: Oil Sources For Parenteral Lipid Emulsionsmentioning

confidence: 95%

Intravenous Lipid Emulsions in Parenteral Nutrition

Fell

Nandivada

Gura

et al. 2015

Advances in Nutrition

119

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Fat is an important macronutrient in the human diet. For patients with intestinal failure who are unable to absorb nutrients via the enteral route, intravenous lipid emulsions play a critical role in providing an energy-dense source of calories and supplying the essential fatty acids that cannot be endogenously synthesized. Over the last 50 y, lipid emulsions have been an important component of parenteral nutrition (PN), and over the last 10-15 y many new lipid emulsions have been manufactured with the goal of improving safety and efficacy profiles and achieving physiologically optimal formulations. The purpose of this review is to provide a background on the components of lipid emulsions, their role in PN, and to discuss the lipid emulsions available for intravenous use. Finally, the role of parenteral fat emulsions in the pathogenesis and management of PN-associated liver disease in PN-dependent pediatric patients is reviewed.

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The metabolic response to intravenous medium-chain triglycerides in infants after surgery

Cited by 33 publications

References 31 publications

Metabolic effects of intravenous LCT or MCT/LCT lipid emulsions in preterm infants

Metabolic effects of intravenous LCT or MCT/LCT lipid emulsions in preterm infants

Parenteral nutrition-associated cholestasis and triglyceridemia in surgical term and near-term neonates: A pilot randomized controlled trial of two mixed intravenous lipid emulsions

Intravenous Lipid Emulsions in Parenteral Nutrition

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