[Elimination and metabolism of MCT-containing fat emulsions in postoperative patients in the framework of total parenteral nutrition].

Abstract

Medium chain triglycerides (MCT) may be particularly well-suited for rapid energy supply in postoperative patients because of their rapid availability. We compared the elimination and metabolization of 10% and 20% MCT/LCT-containing infusions (Lipofundin MCT) in 29 non diabetic patients to 10% and 20% LCT-containing infusions during a course of a 7-day TPN. The speed of the provision of triglycerides does not depend on the composition of the fat emulsions. The maximum TG-levels after fat infusion over 12 hours remained under 3 mmol/l. In the MCT/LCT 20% group we found the lowest half-life of the triglycerides with 77 min at the 1st, 133 min at the 4th, and 72 min at the 7th postoperative day. In addition this group showed persistent low half-lives for free fatty acids: 85 min on day 1, 42 min on day 4, and 39 min on day 7. A comparable liberation of fatty acids in corresponding half-lives could be observed in the LCT-groups only after a course of 7 days: 0.86 resp. 0.69 mmol/l (LCT 10% resp. 20%) on day 1, 1.25 resp. 1.26 mmol/l on day 4, and 1.31 resp. 1.97 mmol/l on day 7. The results of the MCT/LCT 20%-group may be due to a quicker metabolization of these emulsions with favourable availability.