Effects of total parenteral nutrition(TPN) supplemented with medium-chain triglyceride(MCT) in rats with endotoxin-induced sepsis.

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Although lipid is a superior energy source, long-chain triglyceride (LCT) has not been used in septic patients because of its side effects, such as hepatotoxicity and blockade of the reticuloendothelial system. In this study, we evaluated the usefulness of medium-chain triglyceride (MCT) in the treatment of septic rats. Materials and Methods: Rats were fasted and subjected to either fat-free TPN, TPN with LCT, or TPN with MCT. In the fat-treated group, half of the non-protein calories were administered in the form of LCT or MCT. On day 4, 0.8mg/kg or 0.05mg/kg of endotoxin was injected intravenously and survival rates were calculated. In the other study, 0.05mg/kg of endotoxin was injected and 24hrs later blood samples were collected, and at the same time, bacterial translocation (BT) from the gut to the mesenteric lymph nodes, liver and systemic blood was measured. Results: The survival rate was significantly higher in the MCT group (p<0.05), that is, at the 0.8mg/kg dose, 50% in the fat-free group, 33% in the LCT group, and 86% in the MCT group. Severe thrombocytopenia and hepatic dysfunction were recognized only in the LCT group. Although the differences were not significant, the MCT group tended to have a decreased CFU count and decreased incidence of BT. Conclusions: In this model, intravenous administration of MCT improved survival, and this may have been attributable to prevention of BT.
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