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Cited by 35Clinical Nutrition and GastroenterologyGallbladder and Bile Duct DisordersEnhanced Recovery After Surgery

Lack of enteral nutrition during critical illness is associated with profound decrements in biliary lipid concentrationsrted by the Dutch Organization for Scientific Research, project no. 902-23-097.rted by the Dutch Organization for Scientific Research, project no. 902-23-097.rted by the Dutch Organization for Scientific Research, project no. 902-23-097.

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de Vree, J Marleen L, Romijn, Johannes A, Mok, Kam S, Mathus-Vliegen, Lisbeth MH, Stoutenbeek, Chris P, Ostrow, J Donald, Tytgat, Guido NJ, Sauerwein, Hans P +2 more·1999·The American Journal of Clinical Nutrition
DOI 10.1093/ajcn/70.1.70
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Abstract

Background Food in the intestine drives the enterohepatic circulation of bile components.Objective We investigated whether parenteral or enteral delivery of nutrients alters serum and biliary lipids in critically ill patients.Design Eight intensive care unit (ICU) patients who had received >/= 5 d of total parenteral nutrition (TPN) were compared with 8 ICU patients who had fasted for >/=5 d. Both groups were studied before and after 5 d of enteral nutrition (EN). Each patient served as his or her own control. Duodenal bile was analyzed for biliary lipid content and serum lipids were determined simultaneously. Duodenal bile samples from 18 healthy persons served as controls.Results Bile salt concentrations in all ICU patients were 17% of control values before EN (P < 0.005) and 34% of control values after 5 d of EN (P < 0.005). Phospholipid concentrations were 12% of control before EN (P < 0. 0005) but increased almost 4-fold after EN (P < 0.0005). Biliary cholesterol concentrations were 20% of control values before EN (P < 0.001) and did not improve afterward. No difference in bile composition was observed between fasted ICU patients and those who received TPN. The inverse correlation between the severity of illness and biliary lipid concentrations observed before EN disappeared with enteric stimulation. The low serum concentrations of HDL cholesterol and apolipoprotein A-I increased significantly with EN in all ICU patients.Conclusion Lack of EN during critical illness was associated with profound decrements in biliary lipid concentrations that normalized partially after 5 d of EN. We hypothesize that loss of enteric stimulation in ICU patients impairs hepatic lipid metabolism.

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  • In critical illness, bile salt production drops, IgA production is impaired, and the dense mucosal barrier of secreted antimicrobial peptides is lost.

    “bile salt production drops,17 IgA production is impaired,31 and the dense mucosal barrier of secreted antimicrobial peptides is lost.”

    From The microbiome and critical illness (2016) · cites this paper as [17]

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Authors
de Vree, J. M. L., Romijn, J. A., Mok, K. S., Mathus-Vliegen, L. M., Stoutenbeek, C. P., Ostrow, J. D., Tytgat, G. N., Sauerwein, H. P., Elferink, R. P. O., & Groen, A. K.
Affiliations
Amsterdam UMC Location University of Amsterdam (NL)
ORCID
Venue
The American Journal of Clinical Nutrition
Publisher
Elsevier BV
Published
1999-07
Volume
70
Issue
1
Pages
70-77
ISSN
0002-9165 (ISSN-L)
DOI
10.1093/ajcn/70.1.70
OpenAlex
W2155270860
Cited by
35
References
34
Citations by year
2026: 1 · 2025: 1 · 2022: 1 · 2020: 3 · 2019: 1 · 2017: 1 · 2015: 2 · 2014: 3 · 2012: 1
FWCI
1.56
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Clinical Nutrition (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gallbladder and Bile Duct Disorders
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
Keywords
enteral nutrition, critical illness, biliary lipids, bile salts, phospholipids, biliary cholesterol, total parenteral nutrition, fasting, duodenal bile, serum lipids, HDL cholesterol, apolipoprotein A-I, hepatic lipid metabolism, enterohepatic circulation, intensive care unit patients
MeSH terms
Adult, Aged, Aged, 80 and over, Bile, Bile Acids and Salts, Duodenum, Enteral Nutrition, Female, Humans, Intensive Care Units, Lipids, Cholesterol, HDL, Male, Middle Aged, Parenteral Nutrition, Total, Apolipoprotein A-I, Critical Illness

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