INFLUENCE OF DIFFERENT FAT EMULSIONS WITH 10-PERCENT OR 20-PERCENT MCT LCT OR LCT ON LIPOPROTEINS IN PLASMA OF PATIENTS AFTER ABDOMINAL-SURGERY/

In patients after elective abdominal surgery, different fat emulsions were used to compare their efficacy in total parenteral nutrition and in normalizing plasma lipoprotein levels. In five different groups wit h 5 patients each, half of the nonprotein calories were given as mediu m-chain triglycerides/ long-chain triglycerides (1:1) or as long-chain triglycerides alone in 10 or 20% fat emulsions or as glucose alone in a control group for 7 days. After surgery, an initial decrease of all plasma lipoprotein components was followed by a different behavior of glyceride-glycerol, cholesterol, phospholipids, and apolipoproteins. Glyceride-glycerol in very-low-density lipoproteins and high-density l ipoproteins is increasing during infusion of fat emulsions and decreas ing during overnight interruption of infusions. After the 7-day infusi on period, there was no significant difference in very-low-density lip oprotein glyceride-glycerol as compared with the values before differe nt infusions, Low-density lipoprotein cholesterol is reaching and exce eding preoperative concentrations between the 4th and the 7th day, mos t during infusion of 10% fat emulsion and especially due to an increas e of free cholesterol, High-density lipoprotein cholesterol and apolip oprotein A-I reach preoperative levels during infusion of fat emulsion s but not with glucose alone, Higher than preoperative values are reac hed in phospholipids with all fat infusions already on day 4, Abnormal lipoprotein X occurred least with the medium-chain/long-chain triglyc eride 20% fat-infusion. This fat emulsion is suggested as having the b est normalizing effect on plasma lipoproteins and best tolerance in pa tients after surgery.