Cellular Nutrition in Support of Early Multiple Organ Failure (8)

In: Cellular Nutrition

2 Jun 2013

Rats fed MCT demonstrated improved uptake of injected radiolabeled bacteria in the liver, suggesting preserved RES function. LCT requires carnitine for transport into the mitochondria, whereas MCT is not carnitine dependent for ^-oxidation. Hence, MCT provides a readily available fuel source.37 In burn and injury animal models, ketone bodies formed from MCT are energy substrates in the muscle, thus reducing proteolysis from branched-chain amino acid breakdown.-
Ketone development in itself constitutes a ceiling on the amount of MCT that can be administered,36 and the future will probably see patients receiving a combination of the 3 types of lipid described. Whereas nutritionally supported patients in North America currently receive a pure <0-6 LCT lipid source, usually soybean and safflower oil, future lipids may comprise w-6 LCT for essential fatty acids, (*)-3 LCT for the immune modulating effect, and MCT as a readily available fuel source that prevents RES compromise. Incorporation of these lipid moieties onto 1 molecule of glycerol to produce the so-called structured lipid has advantages over a physical mixture of these fats. An LCT/ MCT structured lipid had superior protein-sparing qualities over LCT or a physical mixture of LCT and MCT in a burned-rat model. When fish oil is also incorporated into the structured lipid molecule, its protein-sparing qualities are even more improved in an animal burn model and lactic acidosis is reduced in an endotoxin model (Table 1, Fig 1).

Table 1—Effect of Lipids on Organ Blood Flow m Rats

Control SafflowerOil

Endotoxin

Fish Oil Endotoxin
Cardiac output (ml/min) Liver arterial %

CO Liver venous (ml/min)

Liver total Muscle (ml/g/min)

Skin (ml/g/min)

86.9 ±4.1 5.4 ±0.8

23.5 ±3.7

25.3 ±3.4

0.36 ±0.08

0.20 ±0.09

98.7    ±6.4 10.3±2.1

13.7    ±3.6

23.9 ±6.5

0.11 ±0.04

0.09±0.05

99.1 ±15.8 12.9 ±2.758

19.5 ±2.6

32.3 ±4.95

0.10±0.05

0.10±0.05

Figure-1

Figure 1. Effect of MCT/fish oil structured lipid feeding on lactate formation in guinea pigs challenged with endotoxin. Male guinea pigs were fed diets enriched with either MCT/fish oil structured lipid or safflower oil for 6 wk. Animals received a continuous infusion of E coli endotoxin (15 mg/lcg body weight) or saline (SAL) for 7 h. *p<0.G5 vs SL/LPS, #p<0.G5 vs SO/SAL by two-way ANOVA.


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