Klein M D, Coran A G, Drongowski R A, Wesley J R
J Pediatr Surg. 1983 Dec;18(6):724-31. doi: 10.1016/s0022-3468(83)80012-8.
Intraperitoneal (IP) administration of nutrients would be an attractive alternative to intravenous nutrition since it eliminates intravascular complications. If glucose alone were used as the nonprotein calorie source, associated fluid shifts might not be well tolerated by the patient. A fat emulsion does not have osmotic properties and thus might be incorporated into a program of IP nutrition as a calorie source. Transperitoneal absorption of a commercial fat emulsion (Liposyn 10%, Abbott Laboratories, N Chicago, IL) was studied in 12 beagle puppies divided into two groups. One group received 2.5 gm/kg of fat and the other group received a similar volume of 3.5% crystalline amino acids and 5% glucose in one IP dose. In the first group, the serum triglyceride (TG) increased three fold from 61 +/- 25 mg% to 185 +/- 61 mg% at 15 minutes and then decreased slowly while remaining significantly elevated (p less than 0.05) at 4 hours. 1.94 +/- 0.20 gm/kg of TG were absorbed from the peritoneal cavity over 4 hours. Concommitant IP administration of amino acids and glucose did not affect that absorption. Radiolabeled amino acids and glucose instilled IP were demonstrated in the blood immediately after administration and their absorption was not affected by the presence of a fat emulsion. Plasma free fatty acids showed a small increase at 4 hours (from 0.32 +/- 0.09 mEq/L to 0.59 +/- 0.22 mEq/L). Animals receiving no IP fat showed no change in serum TG. Serum glucose rose in both groups and serum cholesterol showed no changes in either group. Peritoneal fluid accumulation 4 hours after IP fat administration was minimal at 12.7 +/- 6.4 mL/kg. This study shows that a fat emulsion can be quantitatively absorbed from the peritoneal cavity over four hours and that IP nutrition may be feasible.
腹腔内（IP）给予营养物质是静脉营养的一种有吸引力的替代方法，因为它可消除血管内并发症。如果仅使用葡萄糖作为非蛋白质热量来源，相关的液体转移可能无法被患者很好地耐受。脂肪乳剂没有渗透特性，因此可作为热量来源纳入腹腔内营养方案。对12只比格幼犬进行了分组研究，观察一种商业脂肪乳剂（10% Liposyn，雅培实验室，伊利诺伊州芝加哥北区）的经腹膜吸收情况。一组接受2.5克/千克脂肪，另一组接受等体积的3.5%结晶氨基酸和5%葡萄糖的单次腹腔内给药。在第一组中，血清甘油三酯（TG）在15分钟时从61±25毫克%增加到185±61毫克%，增加了三倍，然后缓慢下降，但在4小时时仍显著升高（p<0.05）。4小时内从腹腔吸收了1.94±0.20克/千克的TG。同时腹腔内给予氨基酸和葡萄糖不影响这种吸收。腹腔内注入放射性标记的氨基酸和葡萄糖后，给药后立即在血液中检测到，它们的吸收不受脂肪乳剂存在的影响。血浆游离脂肪酸在4小时时略有增加（从0.32±0.09毫当量/升增加到0.59±0.22毫当量/升）。未接受腹腔内脂肪的动物血清TG无变化。两组血清葡萄糖均升高，两组血清胆固醇均无变化。腹腔内给予脂肪4小时后，腹腔积液最少，为12.7±6.4毫升/千克。这项研究表明，脂肪乳剂可在4小时内从腹腔中被定量吸收，腹腔内营养可能是可行的。
