Does the type of your parenteral lipids matter? A clinical answer in critical illness

Abstract

Background and objectives Disturbance of lipid profile is common among intensive care unit (ICU) patients, but evidence regarding the impact of the different fatty acid (FA) emulsions in patients requiring parenteral nutrition (PN) is scarce. The present study aims to compare the plasma lipid response to 2 types of lipid emulsions [mix of long chain triglycerides (LCT) and medium chain triglycerides (MCT)] or a LCT with n-9 FA in patients requiring prolonged ICU treatment. Methods Retrospective observational study in a multidisciplinary university ICU: 2 periods were defined by the type of industrial lipid emulsion and a lower energy targets in the 2nd period. Inclusion criteria: consecutive patients on PN staying between ≥ 4 and 2 mmol/L. Statistics: two-way analysis of variance (Anova) and linear regression. Results One hundred and eighty-seven patients were included (112 LCT/MCT and 77 LCT n-9FA, respectively): demographic variables, severity indices and diagnostic categories were similar. Outcomes did not differ. Seventy-seven patients (41%) presented hyperTG. The LCT/MCT n group received significantly more daily energy (kcal/day), lipids (g/day), and glucose (g/day), (P Discussion and conclusions The frequent HyperTG during PN, is not associated with adverse outcome. The use of LCT/MCT emulsions is associated with lesser alterations of plasma triglycerides than LCT n-9FA emulsions.