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• W2007139224 abstract "Il n'existe aucune donnée concernant l'utilisation prolongée des triglycérides à chaîne moyenne (TCM) chez l'enfant en nutrition parentérale (NP). Cette étude a porté sur 12 enfants âgés de 1,5 à 17 ans en NP à domicile avec des apports parentéraux quotidiens de 214 ± 92 mg/kg d'azote et de 47 ± 17 Kcal/kg d'énergie non protéique (ENP). L'ENP comportait 10 à 32% de lipides à chaîne longue (TCL) (Intralipide® 20%). Après substitution dose pour dose et au même rythme de l'Intralipide® 20% par une émulsion contenant 50% de TCM et 50% de TCL (Bruneau®), les sujets ont été suivis à 1, 3 et 6 mois. Aucun signe d'intolérance clinique n'a été noté ; parmi les marqueurs biologiques étudiés, les seules modifications significatives (p < 0,05) sont : (1) l'augmentation des apolipoprotéines A1 et A2 à 1, 3 et 6 mois ; (2) la diminution des gamma GT à 6 mois. Le statut en acides gras essentiels (AGE) apprécié dans le plasma et les phospholipides des membranes érythrocytaires ne s'est pas modifié. Une élimination urinaire modérée d'acides dicarboxyliques (adipique, subérique, sébacique) témoigne d'une mise en jeu de l'oméga-oxydation peroxysomale ; ces résultats permettent d'envisager l'administration prolongée d'émulsions riches en TCM compte-tenu de leurs avantages métaboliques par rapport aux TCL. Data concerning the long-term parenteral administration of medium chain triglycerides (MCT) to children are lacking. The goal of this study was to evaluate the effect and tolerance of a 50% LCT/MCT mixture. We studied 12 children (1,5–17 yrs old) who were on TPN for 6 months to 12 years. Cyclic TPN included 4 to 7 nocturnal infusions a week with mean daily intakes of 214 ± 92 mg/kg nitrogen and 47 ± 17 kcal/kg of non-protein energy, including 10 to 32% as lipid (Intralipid® 20%). At the start of the study all the patients were switched to receive a 50% MCT/LCT mixture (Bruneau®) at the same rhythm, amount and rate as before. The following parameters were studied at day 0 and after 1, 3 and 6 months : plasma lipid status including apolipoprotein A-I, A-II, B and essential fatty acids (EFA) (plasma and red blood cells) ; liver function tests, hemoglobin (Hb), platelets (Pt) fibrin (FI), proaccelerin (FV), plasma protein (PP) and bicarbonates (BIC). Twenty-four-hour urine samples were assessed for ketone bodies and dicarboxylic acids. No clinical signs of intolerance were observed ; there was no difference in triglycerides, cholesterol, phospholipid, apo B, EFA, liver function tests results excepts for gammaglutamyl transpeptidase (GGT) or Hb, Pt, FI, FV, PP and BIC. The main differences were a significant increase in apolipoprotein A at 1, 3 and 6 months and a decrease in GGT at the 6th month. Mild urinary excretion of adipic, suberic and sebacic acids appeared at the concentrations of 13.3 ± 5.2, 17.6 ± 11 and 44 ± 39 μmol/mmol creatinin respectively. These results show no clinical or biological side-effects together with a mild benefit concerning Apo A and GGT. Omega oxidation was moderately involved, as demonstrated by urinary dicarboxylic acid excretion ; a 50% reduction in EFA intake did not affect the EFA status of these pediatric patients." @default.
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• W2007139224 date "1990-01-01" @default.
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• W2007139224 title "Nutrition parentérale prolongée chez l'enfant : utilisation de triglycérides à chaîne moyenne" @default.
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• W2007139224 doi "https://doi.org/10.1016/s0985-0562(05)80334-6" @default.
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