Berger M M, Tappy L, Revelly J P, Koletzko B V, Gepert J, Corpataux J M, Cayeux M C, Chiolero R L
Department of Intensive Care Medicine, CHUV, Lausanne, Switzerland.
Eur J Clin Nutr. 2008 Sep;62(9):1116-22. doi: 10.1038/sj.ejcn.1602817. Epub 2007 May 30.
Fish oil (FO) may attenuate the inflammatory response after major surgery such as abdominal aortic aneurysm (AAA) surgery. We aimed at evaluating the clinical impact and safety aspects of a FO containing parenteral nutrition (PN) after AAA surgery.
Intervention consisted in 4 days of either standard (STD: Lipofundin medium-chain triglyceride (MCT): long-chain triglyceride (LCT)50%-MCT50%) or FO containing PN (FO: Lipoplus: LCT40%-MCT50%-FO10%). Energy target were set at 1.3 times the preoperative resting energy expenditure by indirect calorimetry. Blood sampling on days 0, 2, 3 and 4. Glucose turnover by the (2)H(2)-glucose method. Muscle microdialysis.
maximal daily T degrees, intensive care unit (ICU) and hospital stay.
Both solutions were clinically well tolerated, without any differences in laboratory safety parameters, inflammatory, metabolic data, or in organ failures. Plasma tocopherol increased similarly; with FO, docosahexaenoic and eicosapentaenoic acid increased significantly by day 4 versus baseline or STD. To increased postoperatively, with a trend to lower values in FO group (P=0.09). After FO, a trend toward shorter ICU stay (1.6+/-0.4 versus 2.3+/-0.4), and hospital stay (9.9+/-2.4 versus 11.3+/-2.7 days: P=0.19) was observed.
Both lipid emulsions were well tolerated. FO-PN enhanced the plasma n-3 polyunsaturated fatty acid content, and was associated with trends to lower body temperature and shorter length of stay.
鱼油(FO)可能会减轻诸如腹主动脉瘤(AAA)手术等大手术后的炎症反应。我们旨在评估AAA手术后含FO的肠外营养(PN)的临床影响和安全性。
干预措施为连续4天给予标准(STD:Lipofundin中链甘油三酯(MCT):长链甘油三酯(LCT)50%-MCT50%)或含FO的PN(FO:Lipoplus:LCT40%-MCT50%-FO10%)。通过间接测热法将能量目标设定为术前静息能量消耗的1.3倍。在第0、2、3和4天进行血液采样。采用(2)H(2)-葡萄糖法测定葡萄糖周转率。进行肌肉微透析。
每日最高体温、重症监护病房(ICU)住院时间和住院总时间。
两种溶液在临床上耐受性良好,实验室安全参数、炎症、代谢数据或器官功能衰竭方面均无差异。血浆生育酚的增加情况相似;使用FO时,与基线或STD相比,第4天时二十二碳六烯酸和二十碳五烯酸显著增加。术后升高,FO组有降低的趋势(P=0.09)。使用FO后,观察到ICU住院时间有缩短的趋势(1.6±0.4天对2.3±0.4天),住院时间也有缩短趋势(9.9±2.4天对11.3±2.7天:P=0.19)。
两种脂质乳剂耐受性良好。含FO的PN提高了血浆n-3多不饱和脂肪酸含量,并与体温降低和住院时间缩短的趋势相关。