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Hepatocellular integrity after parenteral nutrition: comparison of a fish-oil-containing lipid emulsion with an olive-soybean oil-based lipid emulsion.
Eur J Anaesthesiol 2009; 26(12):1076-82EJ

Abstract

BACKGROUND AND OBJECTIVE

Parenteral nutrition including lipids might be associated with liver disease. The cause leading to parenteral nutrition-related liver dysfunction remains largely unknown but is likely to be multifactorial. The study was performed to assess the effects of a lipid emulsion based on soybean oil, medium-chain triglycerides, olive and fish oil (SMOFlipid20%) compared with a lipid emulsion based on olive and soybean oil on hepatic integrity.

METHODS

In a prospective, randomized, double-blinded trial, 44 postoperative patients with an indication for parenteral nutrition were allocated to one of two regimens: group A (n = 22) received SMOFlipid, group B (n = 22) a lipid emulsion based on olive and soybean oil for 5 days. Aspartate aminotransferase, alanin-aminotransferase, and serum alpha-glutathion S-transferase were measured before the start of parenteral nutrition (d0), at day 2 (d2), and day 5 (d5) after the start of parenteral nutrition. The significance level was defined at a P value of less than 0.05.

RESULTS

There was no significant difference at d0, but at d2 and d5, significantly lower aspartate aminotransferase (d2: group A: 27 +/- 13 vs. group B: 47 +/- 36 U l(-1); d5: A: 31 +/- 14 vs. B: 56 +/- 45 U l(-1)), alanin-aminotransferase (d2: A: 20 +/- 12 vs. B: 42 +/- 39 U l(-1); d5: A: 26 +/- 15 vs. B: 49 +/- 44 U l(-1)), and alpha-glutathion S-transferase levels (d2: A: 5 +/- 6 vs. B: 17 +/- 21 U l(-1); d5: A: 6 +/- 7 vs. B: 24 +/- 27 microg l(-1)) were found in soybean oil, medium-chain triglycerides, olive and fish oil group compared with the control group.

CONCLUSION

Hepatic integrity was well retained with the administration of SMOFlipid whereas in patients receiving a lipid emulsion based on olive and soybean oil liver enzymes were elevated indicating a lower liver tolerability.

Authors+Show Affiliations

Department of Anesthesiology and Critical Care Medicine, Stadtkrankenhaus Frankenthal (Pfalz), Elsa-Brändström-Strasse 1, D-67227 Frankenthal, Germany. swen.n.piper@t-online.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19916246

Citation

Piper, Swen N., 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, vol. 26, no. 12, 2009, pp. 1076-82.
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. Eur J Anaesthesiol. 2009;26(12):1076-82.
Piper, S. N., Schade, I., Beschmann, R. B., Maleck, W. H., Boldt, J., & Röhm, K. D. (2009). 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, 26(12), pp. 1076-82.
Piper SN, et al. Hepatocellular Integrity After Parenteral Nutrition: Comparison of a Fish-oil-containing Lipid Emulsion With an Olive-soybean Oil-based Lipid Emulsion. Eur J Anaesthesiol. 2009;26(12):1076-82. PubMed PMID: 19916246.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatocellular integrity after parenteral nutrition: comparison of a fish-oil-containing lipid emulsion with an olive-soybean oil-based lipid emulsion. AU - Piper,Swen N, AU - Schade,Ingo, AU - Beschmann,Ralf B, AU - Maleck,Wolfgang H, AU - Boldt,Joachim, AU - Röhm,Kerstin D, PY - 2009/11/17/entrez PY - 2009/11/17/pubmed PY - 2010/3/2/medline SP - 1076 EP - 82 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 26 IS - 12 N2 - BACKGROUND AND OBJECTIVE: Parenteral nutrition including lipids might be associated with liver disease. The cause leading to parenteral nutrition-related liver dysfunction remains largely unknown but is likely to be multifactorial. The study was performed to assess the effects of a lipid emulsion based on soybean oil, medium-chain triglycerides, olive and fish oil (SMOFlipid20%) compared with a lipid emulsion based on olive and soybean oil on hepatic integrity. METHODS: In a prospective, randomized, double-blinded trial, 44 postoperative patients with an indication for parenteral nutrition were allocated to one of two regimens: group A (n = 22) received SMOFlipid, group B (n = 22) a lipid emulsion based on olive and soybean oil for 5 days. Aspartate aminotransferase, alanin-aminotransferase, and serum alpha-glutathion S-transferase were measured before the start of parenteral nutrition (d0), at day 2 (d2), and day 5 (d5) after the start of parenteral nutrition. The significance level was defined at a P value of less than 0.05. RESULTS: There was no significant difference at d0, but at d2 and d5, significantly lower aspartate aminotransferase (d2: group A: 27 +/- 13 vs. group B: 47 +/- 36 U l(-1); d5: A: 31 +/- 14 vs. B: 56 +/- 45 U l(-1)), alanin-aminotransferase (d2: A: 20 +/- 12 vs. B: 42 +/- 39 U l(-1); d5: A: 26 +/- 15 vs. B: 49 +/- 44 U l(-1)), and alpha-glutathion S-transferase levels (d2: A: 5 +/- 6 vs. B: 17 +/- 21 U l(-1); d5: A: 6 +/- 7 vs. B: 24 +/- 27 microg l(-1)) were found in soybean oil, medium-chain triglycerides, olive and fish oil group compared with the control group. CONCLUSION: Hepatic integrity was well retained with the administration of SMOFlipid whereas in patients receiving a lipid emulsion based on olive and soybean oil liver enzymes were elevated indicating a lower liver tolerability. SN - 1365-2346 UR - https://www.unboundmedicine.com/medline/citation/19916246/Hepatocellular_integrity_after_parenteral_nutrition:_comparison_of_a_fish_oil_containing_lipid_emulsion_with_an_olive_soybean_oil_based_lipid_emulsion_ L2 - http://Insights.ovid.com/pubmed?pmid=19916246 DB - PRIME DP - Unbound Medicine ER -