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  • Open Access

Effects of an olive oil-based lipid emulsion (ClinOleic) versus LCT/MCT-based lipid emulsions upon the inflammatory markers of critically ill patients (EPICOS Study)

  • 1,
  • 1,
  • 1 and
  • 2
Critical Care201014 (Suppl 1) :P562

https://doi.org/10.1186/cc8794

  • Published:

Keywords

  • Insulin Resistance
  • Delivery System
  • Serum Sample
  • Care Patient
  • Demographic Characteristic

Introduction

Olive oil-based lipid emulsions have been used for more than a decade to reduce the polyunsaturated fatty acid (PUFA) content in TPN, thus preventing the deleterious effects associated with PUFA excess. MCT/LCT-based lipid emulsions were recently associated with deleterious effects such as lipotoxicity, activation of inflammatory cascade and increased risk of cardiovascular disease [1]. This study aims to compare the effects of these two lipid emulsions upon several inflammatory markers in critically ill patients using TPN.

Methods

Serum samples were collected in a prospective multicenter and open-label study (NCT#00798681) from 100 critical care patients receiving TPN with an olive oil-based lipid emulsion using either a premixed ready-to-use system (G1, n = 50, OliClinomel; Baxter) or a compounded system (G2, n = 25, ClinOleic; Baxter), and the results were compared with those from patients receiving a compounded TPN made with an LCT/MCT lipid emulsion (G3, n = 25). All samples were collected at baseline, day 4 and day 7 (three samples in each time point). Changes in the levels of inflammatory markers from baseline to day 7 were compared using analysis of covariance and P < 0.05 was considered statistically significant.

Results

At baseline, demographic characteristics of the patients were balanced between the groups. Regardless of the delivery system used, patients receiving TPN with an olive oil-based lipid emulsion presented at day 4 lower levels of: IL-8 (54.4 vs 67.8 vs 120.7 pg/ml), TNFα (3.4 vs 3.5 vs 13.0 pg/ml), lymphocyte phosphatidylserine externalization (PS) (5.2 vs 4.8 vs 14.7%), and resistin (R) (9.1 vs 9.2 vs 15.4 ng/ml) (all G1 vs G2 vs G3 and P < 0.05). No differences were observed in the levels of IL-10 and CRP. Statistically significant differences were maintained throughout day 7 for IL-8, TNFα, PS and R.

Conclusions

The administration of an olive oil-based lipid emulsion within the TPN regimen led to a significant reduction in the inflammatory response when compared with a LCT/MCT-based lipid emulsion. Particularly relevant are the differences for resistin (an indicator of insulin resistance) and PS (an indicator of apoptosis).

Authors’ Affiliations

(1)
Hospital Fernandes Tavora, Fortaleza, Brazil
(2)
Laboratório Evandro Pessoa, Fortaleza, Brazil

References

  1. Pontes-Arruda : Clin Nutr Suppl. 2009, 4: 19-10.1016/j.clnu.2009.04.006.View ArticleGoogle Scholar

Copyright

© BioMed Central Ltd. 2010

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