Application of a lipid emulsion for parenteral nutrition support in intensive care patients following gastrointestinal surgeries
- VernacularTitle:多种油脂肪乳在胃肠外科重症患者术后肠外营养中的应用
- Author:
Dun PAN
1
;
Hui CHEN
;
Liangqing LI
Author Information
1. 福建医科大学附属第一医院胃肠外科一区
- Keywords:
parenteral lipid emulsion;
parenteral nutrition support;
intensive care;
inflammatory mediators;
liver function
- From:
Journal of Southern Medical University
2015;(9):1312-1315
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of parenteral nutrition support with a lipid emulsion formulation (containing soybean oil, medium chain triglycerides, olive oil, and fish oil [SMOF]) in intensive care patients following major gastrointestinal surgeries. Methods According to a randomized, prospective and case-controlled design, 72 intensive care patients following major gastrointestinal surgeries between January and December, 2014 were randomized equally into SMOF group and control group to receive parenteral nutrition support with SMOF and medium or long chain lipid emulsion, respectively. Before and at 4 and 9 days after commencement of parenteral nutrition support, the patients were examined for alanine aminotransferase (ALT), total bilirubin (TBIL), albumin (propagated), C-reactive protein (CRP), interleukin 6 (IL-6), and endotoxin levels. The patients' average length of stay in intensive care unit (ICU), the days of using antibiotics, and the incidence rate of postoperative complication were recorded. Results On day 4 postoperatively, the levels of CRP and IL-6 were significantly lower in SMOF group than in the control group (t=2.669 and 2.676, respectively; P<0.05), and on day 9, the patients in SMOF group showed significantly lower levels of ALT, TBIL, CRP and IL-6 (t=2.487, 3.497, 3.762, 2.180, respectively;P<0.05) than the control group, but ALB and endotoxin levels remained comparable between the two groups. The average length of stay in ICU and the days of using antibiotics were significantly shorter in SMOF group than in the control group (t=2.94 and 2.17, respectively;P<0.05);SMOF group showed a lower incidence of postoperative infections than the control group, but the difference was not statistically significant (χ2=1.047, P>0.05). Conclusion For intensive care patients following major gastrointestinal surgeries, postoperative parenteral nutrition support with SMOF can effectively reduce the release of inflammatory mediators, protect important visceral functions, reduce postoperative complications, shorten the length of ICU stay, and improve the prognosis of the patients.
