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EC number: 250-705-4
CAS number: 31566-31-1
Long Chain Triglycerides in Parenteral Nutrition
Over the last 3 decades lipid emulsions based on long-chain
triglycerides (LCT) derived from soybean or safflower oil have been used
in parenteral nutrition. For many years, lipid supply was considered as
a means of preventing or correcting essential fatty acid deficiency and
of providing an efficient fuel to many tissues of the body. In the
1970s, the first reports of an interference with the immune system were
published [2, 3] and were confirmed by further observations in the 1980s
 and 1990s . Obviously these effects are related to the dose and
infusion rate of lipid emulsions. The mechanisms are not totally clear,
but an excessive intake of linoleic acid seems to be one of the major
reasons . Therefore, efforts at further developing and optimizing
lipid emulsions have focused on replacing part of the LCT by medium-
chain triglycerides (MCT) synthesized from coconut oil.
Medium Chain Triglycerides in Parenteral Nutrition
Since 1984, a MCT/LCT-containing lipid emulsion has been available on
the European market and later on worldwide. Numerous research teams have
studied the parenteral application of this physical MCT/LCT mixture in a
clinical environment and during long-term home parenteral nutrition
(HPN). MCT have several advantages in comparison to LCT. Because of
their physical and chemical properties, MCT have a better solubility and
are more readily hydrolyzed by lipases. They are more quickly eliminated
from the circulation and taken up by peripheral tissues. They are not
stored as body fat but oxidized more rapidly than LCT. MCT are ketogenic
and consequently both medium- chain fatty acids (MCFA) and ketone bodies
are carnitine-independent substrates. For these and other reasons the
comparison of LCT and MCT with respect to several effects is of interest.
MCT/LCT versus LCT: Conclusion
Directly compared with pure LCT emulsions, MCT/LCT emulsions are a more
efficient fuel, put less strain on the liver, and have significantly
less impact on the immune system and RES function. MCT/LCT emulsions
appear to be of particular benefit to patients with systemic
inflammatory response syndrome or sepsis because, containing only half
the amount of LCT, they supply a significantly smaller amount of n–6
fatty acids and hence of the precursors of potentially immunosuppressive
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