Sepsis hastalarinda total parenteral nutrisyonda lipid seçiminin proinflamatuar sitokinler üzerine etkisithe effect of lipid choice in total parenteral nutrition on proinflamatory cytokine in sepsis patients

Objective: We aimed to compare the inflamatory cytokine levels in patients who diagnosed with sepsis in critical care unit and take parenteral nutrition containing lipids MCT/LCT (long and midium chain fatty acids), LCT and omega-9 (ω-9) and mixed (MCT/LCT, ω-3, ω-9) in this study. Materials and Methods: We included in this study 30 patients who are older than 18 years old, diagnosed sepsis and took total parenteral nutrition. The diagnosis of sepsis was considered due to combination of comfirmed source of infection and SIRS criterias (tachycardia, tachypnia, fever, leucocytosis). Patients were divided into 3 randomized groups in terms of what parenteral nutrition have been taken. GROUP A : (n:10); TPN included MCT/LCT 1g/kg, GROUP B : (n:10); TPN included LCT and ω- 91 g/kg, GROUP C: (n:10); TPN included MCT/LCT, ω-9, ω-3. The first day of patients included in the study started on taking nutrition was admitted as day 0. Blood samples were drawned at the day of 0., 3. and 5; TNF-α, IL-1, IL-6 and IL-8 levels were evaluated. Adverse effects were recorded. Results: 30 patients‟ included in the study median age is 52 (19-81) and 80% of them (24 patients) are male. Patients mean body mass index is 25.1±3.3 kg/cm2 Patients‟ median SOFA score is 5 (4-9). We examined IL-1, IL-6, IL-8 and TNF-α distribution on the day of the first, third and fifth days depending on time but they were not statistically significant (p > 0.05) when we compared the study groups. Conclusion: When we compare MCT/LCT, LCT/ω-9 and MCT/LCT, ω-3, ω-9 which are given as a component of total parenteral nutrition we concluded that there was no superiority to others in terms of proinflamatory cyctocin levels in sepsis and they didn‟t increase proinflamatory cyctocins. Key Words: Sepsis, lipid, total parenteral nutrition