Impact of Intravenous Omega-3-Enriched Lipid Emulsion on Liver Enzyme and Triglyceride Serum Levels of Children Undergoing Gastrointestinal Surgery원문보기
Hanindita, Meta Herdiana
(Department of Child Health, Dr. Soetomo Hospital, Medical School, Airlangga University)
,
Widjaja, Nur Aisiyah
(Department of Child Health, Dr. Soetomo Hospital, Medical School, Airlangga University)
,
Irawan, Roedi
(Department of Child Health, Dr. Soetomo Hospital, Medical School, Airlangga University)
,
Hidayat, Boerhan
(Department of Child Health, Dr. Soetomo Hospital, Medical School, Airlangga University)
,
Hariastawa, IGB Adria
(Department of Pediatric Surgery, Dr. Soetomo Hospital, Medical School, Airlangga University)
Purpose: To investigate the impact of omega-3-enriched lipid emulsion (LE) on liver enzyme (aspartate transaminase [AST] and alanine aminotransferase [ALT]) and triglyceride (TG) levels of children undergoing gastrointestinal surgery. Methods: This experimental randomized controlled group pretest-po...
Purpose: To investigate the impact of omega-3-enriched lipid emulsion (LE) on liver enzyme (aspartate transaminase [AST] and alanine aminotransferase [ALT]) and triglyceride (TG) levels of children undergoing gastrointestinal surgery. Methods: This experimental randomized controlled group pretest-posttest design study included 14 children who underwent gastrointestinal surgery due to duodenal atresia, jejunal atresia, esophageal atresia, and need for parenteral nutrition for a minimum of 3 days at RSUD Dr. Soetomo Surabaya between August 2018 and January 2019. These children were divided into two groups, those who received standard intravenous LE (medium-chain triglyceride [MCT]/long-chain triglyceride [LCT]) and those who received intravenous omega-3-enriched LE. Differences in AST, ALT, and TG levels were measured before surgery and 3 days after the administration of parenteral nutrition. Results: Liver enzyme and TG levels in each group did not differ significantly before versus 3 days after surgery. However, TG levels were significantly lower in the omega-3-enriched intravenous LE group (p=0.041) at 3 days after surgery, and statistically significant difference in changes in TG levels was noted at 3 days after surgery between MCT/LCT intravenous LE group and the omega-3-enriched intravenous LE group (p=0.008). Conclusion: The intravenous omega-3-enriched LE had a better TG-lowering effect than the MCT/LCT intravenous LE in children undergoing gastrointestinal surgery.
Purpose: To investigate the impact of omega-3-enriched lipid emulsion (LE) on liver enzyme (aspartate transaminase [AST] and alanine aminotransferase [ALT]) and triglyceride (TG) levels of children undergoing gastrointestinal surgery. Methods: This experimental randomized controlled group pretest-posttest design study included 14 children who underwent gastrointestinal surgery due to duodenal atresia, jejunal atresia, esophageal atresia, and need for parenteral nutrition for a minimum of 3 days at RSUD Dr. Soetomo Surabaya between August 2018 and January 2019. These children were divided into two groups, those who received standard intravenous LE (medium-chain triglyceride [MCT]/long-chain triglyceride [LCT]) and those who received intravenous omega-3-enriched LE. Differences in AST, ALT, and TG levels were measured before surgery and 3 days after the administration of parenteral nutrition. Results: Liver enzyme and TG levels in each group did not differ significantly before versus 3 days after surgery. However, TG levels were significantly lower in the omega-3-enriched intravenous LE group (p=0.041) at 3 days after surgery, and statistically significant difference in changes in TG levels was noted at 3 days after surgery between MCT/LCT intravenous LE group and the omega-3-enriched intravenous LE group (p=0.008). Conclusion: The intravenous omega-3-enriched LE had a better TG-lowering effect than the MCT/LCT intravenous LE in children undergoing gastrointestinal surgery.
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문제 정의
This study aimed to investigate the impact of omega-3-enriched LE on liver enzyme (aspartate transaminase [AST] and alanine transaminase [ALT]) and TG levels in children undergoing gastrointestinal surgery.
제안 방법
Soetomo Surabaya took part in this study; all already met the inclusion and exclusion criteria. The study participants were classified into two groups: that receiving the MCT/LCT intravenous LE, and that receiving the omega-3-enriched intravenous LE.
This experimental randomized controlled group pretest-posttest design study aimed to explain the effect of omega-3-enriched LE in parenteral nutrition therapy on liver function and TG levels in pediatric patients post gastrointestinal surgery compared to standard LEs.
대상 데이터
Fourteen pediatric inpatients at RSUD Dr. Soetomo Surabaya took part in this study; all already met the inclusion and exclusion criteria. The study participants were classified into two groups: that receiving the MCT/LCT intravenous LE, and that receiving the omega-3-enriched intravenous LE.
Participants of this study were pediatric patients undergoing gastrointestinal surgery at RSUD Dr. Soetomo Surabaya between August 2018 and January 2019, with the inclusion criteria of 0-18 years of age, having undergone gastrointestinal surgery due to duodenal atresia, jejunal atresia, or esophageal atresia; patients requiring parenteral nutrition for at least 3 days; and willingness to participate in the study (informed consent provided by their parents/guardians). The exclusion criteria of this study were one or more chronic diseases involving the heart, liver, or kidney; and history of fish/egg/soy/nut protein allergy.
데이터처리
Differences in liver function levels, namely AST and ALT, and TG levels were measured before surgery and 3 days after the administration of parenteral nutrition. Statistical analyses were performed using paired sample t-tests to investigate the effect of omega-3-enriched intravenous LEs on liver function and TG levels.
성능/효과
In conclusion, based on the results of this study, the administration of intravenous omega-3-enriched LE as parenteral nutrition therapy significantly lowers the TG levels of children undergoing gastrointestinal surgery compared to the standard intravenous LE and has no significant effect on liver enzyme levels.
In this study, levels of hemoglobin, leukocytes, C-reactive protein (CRP), AST, ALT, albumin, and TG did not differ significantly before versus 3 days after surgery in either group (Table 2). However, TG levels were significantly higher in the MCT/LCT intravenous LE group compared to the omega-3-enriched intravenous LEs group (p=0.
As a result, hyperlipidemia may occur in patients receiving parenteral nutrition after surgery [19]. In this study, postoperative TG levels in the omega-3-enriched intravenous LE group were significantly lower than those in the MCT/LCT intravenous LE group.
Wilk reported that the consumption of fish or fish oil can reduce cardiovascular risk by decreasing TG level. Our study findings are like those of a study of a healthy population that showed that intravenous LEs enriched in fish oil significantly improved lipid profile and counteracted dyslipidemia. More efficient TG elimination by omega-3-enriched intravenous LEs than LCT intravenous LEs has been reported by several studies in postoperative patients [20].
There was no statistically significant intergroup difference in changes in laboratory parameters for hemoglobin, leukocytes, CRP, AST, ALT, or albumin at 3 days postoperative. This study showed statistically significant difference in changes in TG levels at 3 days postoperative between the MCT/LCT intravenous LE group and the omega-3-enriched intravenous LE group (p=0.
This study showed no significant differences in laboratory parameters such as hemoglobin, leukocytes, CRP, albumin, AST, and ALT, before surgery or 3 days after surgery, between the MCT/LCT intravenous LE group and the omega-3-enriched intravenous LE group. These results are in accordance with those of several previous studies [11-13].
There was no statistically significant intergroup difference in changes in laboratory parameters for hemoglobin, leukocytes, CRP, AST, ALT, or albumin at 3 days postoperative. This study showed statistically significant difference in changes in TG levels at 3 days postoperative between the MCT/LCT intravenous LE group and the omega-3-enriched intravenous LE group (p=0.008) (Table 4).
참고문헌 (20)
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