Clinical nutrition : official journal of the European Society of Parenteral and Enteral Nutrition
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Randomized Controlled Trial Comparative Study Clinical Trial
Use of a mixture of medium-chain triglycerides and longchain triglycerides versus long-chain triglycerides in critically ill surgical patients: a randomized prospective double-blind study.
Twenty critically-ill surgical patients who needed total parenteral nutrition were randomly enrolled in a double-blind study comparing two intravenous fat emulsions: one containing a mixture of 50% medium-chain triglycerides and 50% long-chain triglycerides and another containing 100% longchain triglycerides. The purpose of this study was to investigate metabolic and biochemical differences between both emulsions with special reference to liver enzymes. After a baseline period of 24 h with only glucose and NaCl infusion, the lipid emulsion was added continuously during 24 h over 5 days. ⋯ There was no significant difference in energy expenditure, nitrogen balance, liver function tests, carnitine, transferrin, pre-albumin, albumin, cholesterol, triglycerides and free fatty acids. The only parameter that showed a different pattern of reaction between the two emulsions was serum bilirubin concentration. In this study no evidence of any advantageous effect of a mixture of medium-chain triglycerides and long-chain triglycerides was seen.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison between two fat emulsions: Intralipid 30 cent vs intralipid 10 cent in critically ill patients.
Fat emulsions, Intralipid 30% and Intralipid 10% were compared in terms of the resulting plasma levels of different lipid components and clinical tolerance in critically-ill patients with multi-injuries. Sixteen critically-ill patients with severe systemic inflammatory response were randomly assigned to two groups, each one comprised of eight patients. Each group was administered the same quantity of fat/Kg/day either Intralipid 30% or Intralipid 10%. ⋯ On the contrary, there was an increase in LpX in the Intralipid 10% group. From the above findings, we draw the conclusion that Intralipid 30% revealed better profiles of different lipid components than Intralipid 10% in critically-ill patients. The new emulsion of higher concentration in triglyceride was proved clinically safe and its use is suggested for critically-ill patients who require total parenteral nutrition.
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It was previously demonstrated that single frequency bio-electrical impedance (BIA) measurement at 50 kHz is a useful method to assess total body water (TBW) in patients with chronic obstructive pulmonary disease (COPD). In the present study it was examined whether bio-electrical impedance spectroscopy (BIS) could predict extracellular water (ECW) and improve the prediction of TBW in these patients. TBW and ECW (corrected bromide space) were measured by deuterium and bromide dilution. ⋯ Predicted ECW using BIS-measurements was not significantly different from measured ECW (male symbol r = 0.75, SEE: 1.4 L, female symbol r = 0.73, SEE: 1.2 L), but the error in the prediction was relatively large and the correlation between predicted and actual ECW relatively low compared to most studies in healthy subjects. Predicted TBW using BIS was comparable to actual TBW, but presented no improvement of the prediction of TBW using BIA at 50 kHz and a patient specific regression equation. The error of the prediction of ECW by BIS limits the ability to predict fluid shifts in individual patients with clinically stable COPD.