EFFECTS OF FAT INFUSION IN PATIENTS AFTER MULTIPLE TRAUMA

Objectives: To study the metabolic effects of a high-dose fat infusion application in the early phase of total parenteral nutrition (TPN) af ter major trauma. Design: Prospective study in male patients after maj or trauma. Setting: Intensive care unit of the University Clinic. Pati ents: 21 male, mechanically ventilated patients after major trauma. In terventions: Infusion of Elolipid(R) 20% (Fa. Leopold, Graz, Austria), starting on the 3rd day after ICU admission (0.075 g/kg body weight/h ) in 8 h. The dose was increased on the 5th day (0.125 g/kg BW/h) and on the 7th day (0.15 g/kg BW/h). Results: There was a pathologic rise in serum triglycerides on days 3, 5 and 7 during the infusion period. A serious diabetic metabolic state was shown on the 3rd day. No signif icant changes in urea production rate could be demonstrated after the high-dose fat infusion. Conclusions: The reason for the decreased fat elimination in patients after major trauma after high-dose fat infusio n (8 h) remains unclear (fat clearance or fat oxidation failure). Ther efore the fat infusion should be started after normalization of the bl ood glucose level. Thus the fat infusion should be given continuously over 24 h to avoid serious metabolic complications.