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EC number: 293-208-8 | CAS number: 91052-47-0
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 prostaglandins.
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