2012, Number 2
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Med Crit 2012; 26 (2)
Behavior of liver function tests related to the use of different lipid emulsions in critically ill
Flores CJC, Sánchez NVM, Muñoz RMR, Chávez PCE, Hernández RG, Esparza OLP
Language: Spanish
References: 13
Page: 80-84
PDF size: 78.68 Kb.
ABSTRACT
Background: Lipids are important for the function of cell membrane and precursors of prostaglandins and eicosanoids. N-3 lipids have been recognized for its potential as an immunomodulator, and liver protector. The goal is to find relationship between the use of different lipid emulsions and the presence of liver disorders.
Material and methods: Observational, retrospective, transversal. Patients with parenteral nutrition for more than 48 hours with biochemical control of cholesterol, FA, AST, ALT, BT, admitted February 2010 to July 2011. Were divided into 2 groups: group 1 received Lipovenoes (20%), MCT/LCT or Lipofundin (20%), and group 2 received Smofflipid (20%).
Results: 49 cases. Male 59% Female 41% age 56.91 years SD ± 21.56, stay 15 days ± 15.9, BMI 26.2 SD ± 5.39; exclusive parenteral nutrition 20.4%, mixed 79.6%, days of parenteral nutrition 9.7 of ± 7.7. Group 1 to 7° days increased cholesterol are 5.8%, FA 92.8%, 33.3% AST, ALT 64%, and total bilirubin 30.7%, Group 2 cholesterol increased 21%, FA 94.7%, 33.3% AST, ALT 55.5% and total bilirubin 26.3%.
Conclusions: The use of Smofflipid is associated with elevation of alanine aminotransferase less and bilirubin.
REFERENCES
Ziegler TR. Parenteral nutrition in the critically ill patient. The New England Journal of Medicine 2009;361(11):1088-1097.
Singer P, Berger MM, Berghe G, Van den, et al. ESPEN guidelines on parenteral nutrition: Intensive care. Clinical nutrition (Edinburgh, Scotland) 2009;28(4):387-400.
Martindale RG, McClave SA, Vanek VW, et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition: Executive Summary. Critical Care Medicine 2009;37(5):1757-61.
Calder PC, Jensen GL, Koletzko BV, Singer P, Wanten GJA. Lipid emulsions in parenteral nutrition of intensive care patients: current thinking and future directions. Intensive Care Medicine 2010;36(5):735-49.
Piper SN, Schade I, Beschmann RB, et al. Hepatocellular integrity after parenteral nutrition: comparison of a fish-oil-containing lipid emulsion with an olive-soybean oil-based lipid emulsion. European Journal of Anaesthesiology 2009;26(12):1076-1082.
Stapleton RD, Martin JM, Mayer K. Fish oil in critical illness: Mechanisms and clinical applications. Critical Care Clinics 2010;26(3):501-14, ix.
Tsoras M. Immunonutrition as a part of the nutritional support of critically ill patients. Contemporary Critical Care 5.
Dodek P, Kozak J-F, Norena M, Wong H. More men than women are admitted to 9 intensive care units in British Columbia. Journal of Critical Care 2009;24(4):630.e1-8.
Elke G, Schädler D, Engel C, et al. Current practice in nutritional support and its association with mortality in septic patients–results from a national, prospective, multicenter study. Critical Care Medicine 2008;36(6):1762-7.
Ukleja A, Romano MM. Complications of parenteral nutrition. Gastroenterology Clinics of North America 2007;36(1):23-46, v.
Puder M, Valim C, Meisel JA, et al. Parenteral fish oil improves outcomes in patients with parenteral nutrition-associated liver injury. Annals of Surgery 2009;250(3):395-402.
Fallon EM, Le HD, Puder M. Prevention of parenteral nutrition-associated liver disease: role of w-3 fish oil. Current Opinion in Organ Transplantation 2010;15(3):334-340.
Pratt DS. 73 Liver chemistry and function tests. Ninth Edit. Copyright© 2010, 2006, 2002, 1998, 1993, 1989, 1983, 1978, 1973 by Saunders, an imprint of Elsevier Inc. 1227-1238.