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Improved fatty acid and leukotriene pattern with a novel lipid emulsion in surgical patients

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Summary

Objective

We assessed the effects of a novel lipid emulsion with reduced content of n–6 fatty acids (FA), increased share of MUFA and n–3 FA and supplemental vitamin E on fatty acid and leukotriene pattern in surgical patients.

Methods

In a double–blind, randomized study 33 patients received isonitrogenous, isocaloric TPN over 5 postoperative days following major abdominal surgery. 19 patients received the new SMOFlipid® 20% and 14 patients a standard soybean oil emulsion (Lipovenoes® 20%, both Fresenius Kabi), each 1.5 g fat/kg body weight (BW)/d. Routine lipid biochemistry, plasma tocopherol, fatty acid pattern in plasma phospholipids, as well as leukotriene (LT) release in leukocytes were assessed. Additionally, fatty acid pattern in leukocyte and platelet phospholipids were analysed, but results are not presented.

Results

On day 6, plasma α–tocopherol (34.2 ± 10.3 vs. 17.6 ± 2.9 µmol/L) and, in plasma PL, total n–3 FA were higher (11.1 ± 1.9 vs. 4.9 ± 0.9 mol%; p < 0.05) and total n–6 FA lower (23.8 ± 2.2 vs. 31.8 ± 1.7 mol%; P < 0.05); the ratio n–3/n–6 FA being elevated (0.5 ± 0.1 vs. 0.2 ± 0.0 p < 0.05) with SMOFlipid compared to the soybean oil emulsion. The shares of EPA (3.3±1.0 vs. 0.4±0.2 mol%; p<0.05) and DHA (6.9 ± 1.8 vs. 3.7 ± 0.8 mol%; p < 0.05) were highly increased but that of arachidonic acid (AA) was unchanged with SMOFlipid while the ratio EPA/AA was increased (0.7 ± 0.2 vs. 0.1 ± 0.0 p < 0.05). LTB5 release was enhanced on day 6 (8.1 ± 5.3 vs. 1.8 ± 3.8 pmol/107 PMN, p < 0.05) and liberation of LTB4 was lowered, yet not significantly with SMOFlipid (124.0 ± 51.2 vs. 152.1 ± 68.8 pmol/107 PMN). Length of hospital stay was significantly shorter with SMOFlipid (13.4 ± 2.0 vs. 20.4 ± 10.0 days, p < 0.05).

Conclusion

Treatment with the new emulsion SMOFlipid is well tolerated and modulates FA and leukotriene pattern suggesting favourable anti–inflammatory effects and further clinical benefits.

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Author information

Authors and Affiliations

  1. Clinic for General, Visceral, Thoracic, Vascular and Pediatric Surgery, Clinical Centre Passau, Innstr. 76, 94032, Passau, Germany

    H. Grimm

  2. Dept. of Anaesthesiology and Intensive Care, Raphaelsklinik, Münster, Germany

    N. Mertes

  3. Dept. of Anaesthesiology and Intensive Care, University of Münster, Münster, Germany

    C. Goeters

  4. Fresenius Kabi, Bad Homburg, Germany

    E. Schlotzer

  5. Dept. of Internal Medicine and Intensive Care, University of Gießen, Gießen, Germany

    K. Mayer & F. Grimminger

  6. Institute for Nutritional Sciences, University of Bonn, Bonn, Germany

    P. Fürst †

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  1. H. Grimm
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  2. N. Mertes
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  3. C. Goeters
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  4. E. Schlotzer
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  5. K. Mayer
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  6. F. Grimminger
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  7. P. Fürst †
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Correspondence to H. Grimm.

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Grimm, H., Mertes, N., Goeters, C. et al. Improved fatty acid and leukotriene pattern with a novel lipid emulsion in surgical patients. Eur J Nutr 45, 55–60 (2006). https://doi.org/10.1007/s00394-005-0573-8

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  • DOI: https://doi.org/10.1007/s00394-005-0573-8

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