linoleic-acid and Wounds-and-Injuries

Although the barrier function of the intestinal mucosa is impaired after hemorrhage, it remains unclear whether this is associated with a deficit in mucosal function. The aim of this study, therefore, was to determine whether trauma-hemorrhage affects the in vivo lipid absorptive capacity of the gut and, if so, to characterize the uptake process of free fatty acids in isolated enterocytes. To study this, rats were anesthetized, a laparotomy was performed (i.e., trauma was induced), and various blood vessels were cannulated. For in vivo lipid absorption, the main intestinal lymph vessel was cannulated and a jejunostomy feeding tube was inserted. The animals were bled to and maintained at a mean arterial pressure of 40 mmHg until 40% of shed blood volume was returned in the form of Ringer lactate. They were then resuscitated with four times the volume of maximal bleed out with Ringer lactate. The in vivo and in vitro lipid absorptive capacities were assessed by measuring lymph triglyceride output after a fat load and by determining the linoleic acid uptake rates on isolated enterocytes, respectively. The results show that the in vivo lipid absorption capacity of the gut is severely depressed after trauma-hemorrhage and resuscitation. Similarly, in enterocytes isolated from hemorrhaged rats, fatty acid uptake capacity, as reflected by the decreased maximal uptake rates, was significantly reduced: 1.2 +/- 0.2 and 2.6 +/- 0.6 nmol.min-1 x 10(6) cells-1 for hemorrhaged and sham, respectively. Thus gut lipid absorptive function is depressed after trauma-hemorrhage and resuscitation, which is at least partially due to the depressed uptake mechanism of the enterocyte.

Topics: Animals; Cell Separation; Hemorrhage; Intestinal Absorption; Intestinal Mucosa; Intestines; Linoleic Acid; Linoleic Acids; Lipid Metabolism; Male; Rats; Rats, Sprague-Dawley; Resuscitation; Wounds and Injuries

Topics: alpha-Linolenic Acid; Cholesterol, HDL; Cholesterol, LDL; Creatinine; Dietary Fats; Female; Food, Formulated; Humans; Linoleic Acid; Linoleic Acids; Linolenic Acids; Pain; Potassium; Prostaglandins; Sodium; Wounds and Injuries

After a heavy injury there are characteristic changes of plasma lipids and lipoproteins. In 7 patients up to 40 days after major injury the fatty acids of cholesteryl esters, phospholipids and triglycerides in plasma under the influence of injury, parenteral nutrition with carbohydrates or fat, and protein-sparing therapy were determined by gas liquid chromatography. These patients' increased requirement for linoleic acid is further increased by up to more than 50 g per day by carbohydrate-rich parenteral nutrition, inhibiting lypolysis of linoleic acid from adipose tissue. Protein-sparing therapy without carbohydrates is not sufficient to cover the patients' increased requirement for linoleic acid. Thus, the early administration of fat emulsions in parenteral nutrition is recommended.

Topics: 8,11,14-Eicosatrienoic Acid; Adolescent; Adult; Aged; Arachidonic Acid; Arachidonic Acids; Cholesterol; Dietary Carbohydrates; Dietary Fats; Fatty Acids, Essential; Female; Humans; Linoleic Acid; Linoleic Acids; Male; Middle Aged; Parenteral Nutrition; Wounds and Injuries

In sepsis the utilization of endogenous and administered fuel sources is sometimes impaired. The precise origin of this metabolic failure is currently unknown. In long term and severe septic processes an increased peripheral energy deficit appears accompanied by a drastically augmented muscle protein catabolism. Branched chain amino acids released by this protein breakdown, at least temporarily, meet the energy needs of the muscles. Ketone bodies as energy source for the muscle are not available because their production is diminished in sepsis. The question of whether or not fat emulsions can be administered to septic patients still remains unanswered, although some recent investigations have demonstrated that fat is utilized and oxidized by septic patients. Results from our patients indicate that a marked reduction of cholesterin ester quotient, an increase of total and VLDL triglycerides and a severe reduction of HLDL Cholesterin are particularly characteristic changes in lipid metabolism during sepsis. The proportional decrease of the linoleic acid levels in cholesterol esters of plasma observed in septic patients was even more pronounced followed severe injury. Together with others we believe that parenteral fat application is not contraindicated in sepsis. The decision to infuse fat emulsions depends more on the metabolic situation of a patient than on a specific diagnosis; in other words, a sufficient peripheral oxygen supply, the level of the serum triglycerides and the reaction of the blood glucose concentration to an intravenously administered fat emulsion are, among others, the decisive factors.

Topics: Adult; Cholesterol; Cholesterol Esters; Energy Metabolism; Fat Emulsions, Intravenous; Humans; Linoleic Acid; Linoleic Acids; Lipoproteins; Liver; Male; Sepsis; Surgical Wound Infection; Triglycerides; Wounds and Injuries

Topics: alpha-Linolenic Acid; Humans; Linoleic Acid; Psychotherapy; Wound Healing; Wounds and Injuries