Identificador: TDX:649
Autors:
Baeta Capellera, Eduard
Resum:
BACKGROUND: Nutritional status of patients undergoing major surgical procedures is and important issue as far as their outcome is concern and total parenteral nutrition (TPN) has been used on a regular basis. Several protocols have resulted in different lipoprotein profiles. AIM OF THE STUDY: We have tried to evaluated the influence of a TPN given on a constant composition, rhythm and perfusion rate on the lipoprotein profile. Quantitative and qualitative variations were evaluated in subjects in whom major surgical interventions were necessary (Group I). Major surgical procedures effect, on lipoprotein composition and postbeparin lipase activity, was studied In a second group of patients not requiring TPN (Group H). SUBJECTS AND METHODS: Seventy five patients were investigated with their full informed consent. Fifty five patients requiring TNP for at least eight days composed group I. Group H was recruited from surgical patients undergoing similar surgical procedures, during the same time period, but not requiring TPN. Lipoprotein fractions were obtained by sequential ultracentrifugation as described by Havel. In group 11, LPL and HL activity were also studied. RESULTS: Plasma (P) Cholesterol (P-Col), phospholipids (P-P1), apo-B (P-apoB) and PI in all fractions were increased as the result of TPN. Plasma triglycérides (P-Tg) suffered a slow but significant Increase. Col, Tg and PI In VLDL, IDI, and LDL showed progressively higher values, most Important in the LDL fraction. Higher significant values for Tg and PI are found, too, in HDLj and HDIvj. On the fourth day LpX was observed in 28.57% of the patients. There was a significant correlation between the increase of PI-LDL and nutritional parameters score. Patients on major surgery not requiring TPN showed an important
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