29 Fatty acid utilization of MCT containing fat emulsion in newborn infants

Abstract

Medium-chain triglycerides(MCT)are applied mainly in enteral nutrition of newborn infants. As results of oxidative utilization of MCT after parenteral application have' not yet been published, we investigated MCT oxidation in neonates using the ¹³C trioctanoin breath test. We carried out 16 breath tests on 11 newborn patients between the first and the thirty-fifth day of life. The patients were nourished with 1,0-6,7g/kg/day glucose i.v., 1,0-2,3g/kg/day 1-amino acids i.v., 1,0g/kg/day fat emulsion i.v. and 12-183ml/kg/day formula. They received parenterally 10mg/ kg 1-¹³C₃ trioctanoin emulsified with Lipofundin MCT/LCT 10% R. The expired ¹³CO₂ resulting from fat oxidation was determined by the use of a ratio-mass-spectrometer. The amount of ¹³C contained in the expired air gives the rate of the fatty acid oxidation. Within 8 hours between 31,6% and 89,6% of the applied tracer amount was oxidized. The fatty acid oxidation showed a significant negative correlation with simultaneous supply of carbohydrates (r=-O,95, p<0,001). The oxidation rates of MCT were about twice as high as those of long-chain triglycerides. Because of their high energetic level MCT-containing fat emulsions are, in principle, also suitable for parenteral nutrition of newborn infants. The oxidative MCT utilization, is apparently reduced by a high carbohydrate intake. Therefore, the simultaneous administration of carbohydrates must be considered during i.v.supply of MCT-containing fat emulsion. Further investigations are necessary before recommendation can be given for clinical application in neonates.

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