1.
Structured lipid emulsion as nutritional therapy for the elderly patients with severe sepsis.
Chen, J, Yan, J, Cai, GL, Xu, QH, Gong, SJ, Dai, HW, Yu, YH, Li, L
Chinese medical journal. 2013;(12):2329-32
Abstract
BACKGROUND The nutritional support is one of the important therapeutic strategies for the elderly patients with severe sepsis, but there is controversial in choosing a parenteral nutrition formulation. This study was designed to compare the therapeutic effects of structured lipid emulsion, physically mixed medium, and long-chain fat emulsion in the treatment of severe sepsis in elderly patients. METHODS A total number of 64 elder patients with severe sepsis were enrolled in the study. After a week of enteral nutritional support, the patients were randomly divided into research (structured lipid emulsion as parenteral alimentation) and control groups (physically mixed medium and long-chain fat emulsion as parenteral alimentation). The alterations of plasma albumin, lipid metabolism, and blood glucose level were recorded after parenteral alimentation and were compared between the two groups. RESULTS The plasma levels of albumin, prealbumin, cholesterol, and triglyceride were decreased in all the patients after one week of enteral nutritional support treatment (t = 7.78, P = 0.000; t = 10.21, P = 0.000; t = 7.99, P = 0.000; and t = 10.99, P = 0.000). Further parenteral alimentation with different lipid emulsions had significant effects on the serum prealbumin and albumin (t = 3.316, P = 0.002; t = 3.200, P = 0.002), whilst had no effects on the blood glucose and triglyceride level (t = 7.78, P = 0.000; t = 4.228, P = 0.000). In addition, the two groups had a significantly different Apache II score, ventilator time, and hospital stay time (t = -2.213, P = 0.031; t = 2.317, P = 0.024; t = 2.514, P = 0.015). CONCLUSIONS The structured lipid emulsion was safe as parenteral nutrition for elderly patients with severe sepsis. It was demonstrated to be superior to the physically mixed medium and long-chain fat emulsion with respect to the protein synthesis and prognosis.
2.
The effects of a short-term long-chain-triglyceride infusion on the postoperative immune function of pediatric patients receiving a gastrointestinal surgical procedure.
Li, X, Ying, J, Zeng, S, Li, Y, Yang, H, Shen, L, Han, J, Chen, J, Shen, H
JPEN. Journal of parenteral and enteral nutrition. 2008;(1):72-7
Abstract
OBJECTIVE This clinical trial investigates whether short-term administration of long chain triglycerides (LCT) has any influence on the immune function in children following gastrointestinal surgery. METHODS Sixty pediatric patients receiving a gastrointestinal operation were randomly divided into the experimental group (n = 36) and the control group (n = 24). After abdominal operation, the subjects received parenteral nutrition (PN) support with or without LCT for 5 days. The patients' fasting blood samples were respectively collected at 24 hours preoperative, then 24 hours and 120 hours postoperative. Blood parameters related to the patients' immune function were measured. RESULTS Before surgery and LCT treatment, the experimental group and control group did not differ significantly in overall state of health. Except for a small increase of serum IgM at 24 hours postsurgery (p < .05), all parameters representing the patients' immune function showed no significant difference between the LCT group and the control group with respect to peripheral blood mononuclear cell (PBMC), T lymphocyte, CD4, CD8, CD4/CD8, serum immunoglobulin A (IgA), IgG, IgM, complement C3, C4, interleukin (IL)-2, IL-4, IL-10, IL-12, tumor necrosis factor (TNF)-alpha and IFN-gamma (p > .05, respectively) before the operation, 24 hours and 120 hours after the operation. CONCLUSIONS A short-term LCT administration at an appropriate dosage and infusion speed does not alter the pediatric patients' immune function after gastrointestinal surgery. The etiology and clinical significance of the slightly increased IgM 24 hours postsurgery need to be further investigated.