Randomized clinical trial of new intravenous lipid (SMOFlipid 20%) versus medium-chain triglycerides/long-chain triglycerides in adult patients undergoing gastrointestinal surgery

JPEN J Parenter Enteral Nutr. 2014 Sep;38(7):800-8. doi: 10.1177/0148607113512869. Epub 2013 Nov 27.

Abstract

Background: SMOFlipid 20% is intravenous lipid emulsion (ILE) containing long-chain triglycerides (LCT), medium-chain triglycerides (MCT), olive oil, and fish oil as a mixed emulsion containing α-tocopherol. The aim was to assess the efficacy of this new ILE in gastrointestinal surgery compared with MCT/LCT.

Methods: In this prospective study, 40 patients were randomized to SMOFlipid 20% or MCT/LCT (Lipovenoes 20%) group. Clinical and biochemistry data were collected. Inflammatory markers (CRP, IL-6, IL-10, TNF-α, TGF-β1) and oxidative stress (ROS and superoxide) were measured.

Results: Thirty-five patients (17 males and 18 females) with a mean age of 57 years completed the study. The patients' demographic characteristics (age, gender, height, body weight, and BMI) were similar without significant differences between groups. The increment of triglyceride on day 6 from baseline was significantly lower in SMOFlipid group than in Lipovenoes MCT/LCT group. Inflammatory markers, as well as superoxide radical and total oxygen radical were not different between groups.

Conclusions: Despite the comparable effect on inflammatory response, because of its well-balanced fatty acid pattern, relatively low n-6:n-3 ratio, and high vitamin E content, SMOFlipid had a better triglyceride-lowering effect as compared with MCT/LCT in adult patients undergoing gastrointestinal surgery.

Keywords: inflammatory markers; intravenous lipid emulsions; oxidative stress; postoperative nutrition; prospective randomized study; triglyceride.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • C-Reactive Protein / metabolism
  • Cytokines / blood
  • Digestive System Surgical Procedures*
  • Fat Emulsions, Intravenous / chemistry
  • Fat Emulsions, Intravenous / pharmacology*
  • Fatty Acids / blood
  • Fatty Acids / pharmacology*
  • Female
  • Fish Oils / chemistry
  • Fish Oils / pharmacology
  • Humans
  • Inflammation Mediators / blood*
  • Lipids / blood
  • Lipids / pharmacology
  • Male
  • Middle Aged
  • Olive Oil
  • Oxidative Stress / drug effects*
  • Parenteral Nutrition
  • Plant Oils / chemistry
  • Plant Oils / pharmacology
  • Postoperative Care*
  • Prospective Studies
  • Reactive Oxygen Species / blood
  • Soybean Oil / chemistry
  • Soybean Oil / pharmacology
  • Triglycerides / blood
  • Triglycerides / pharmacology*
  • alpha-Tocopherol / pharmacology

Substances

  • Cytokines
  • Fat Emulsions, Intravenous
  • Fatty Acids
  • Fish Oils
  • Inflammation Mediators
  • Lipids
  • Olive Oil
  • Plant Oils
  • Reactive Oxygen Species
  • Triglycerides
  • Soybean Oil
  • C-Reactive Protein
  • alpha-Tocopherol