INTRODUCTION: Our study aim was to assess how the macronutrient intake during total parenteral nutrition (TPN) modulates plasma total free fatty acids (FFAs) levels and individual fatty acids in critically ill patients. METHOD: Adult patients aged 18-80, admitted to the intensive care unit (ICU), who were indicated for TPN, with an expected duration of more than three days, were included in the study. Isoenergetic and isonitrogenous TPN solutions were given with a major non-protein energy source, which was glucose (group G) or glucose and lipid emulsions (Smof lipid; group L). Blood samples were collected on days 0, 1, 3, 6, 9, 14, and 28. RESULTS: A significant decrease (p < 0.001) in total FFAs occurred in both groups with a bigger decrease in group G (p < 0.001) from day 0 (0.41 ± 0.19 mmol∙L-1) to day 28 (0.10 ± 0.07 mmol∙L-1). Increased palmitooleic acid and decreased linoleic and docosahexaenoic acids, with a trend of increased mead acid to arachidonic acid ratio, on day 28 were observed in group G in comparison with group L. Group G had an insignificant increase in leptin with no differences in the concentrations of vitamin E, triacylglycerides, and plasminogen activator inhibitor-1. CONCLUSION: Decreased plasma FFA in critically ill patients who receive TPN may result from increased insulin sensitivity with a better effect in group G, owing to higher insulin and glucose dosing and no lipid emulsions. It is advisable to include a lipid emulsion at the latest from three weeks of TPN to prevent essential fatty acid deficiency.

• Klíčová slova
• adiponectin, alpha-Tocopherol, critical illness, essential fatty acids deficiency, insulin resistance, nonesterified fatty acids, parenteral nutrition,
• MeSH
• alfa-tokoferol krev   MeSH
• emulze aplikace a dávkování   MeSH
• esenciální mastné kyseliny krev   nedostatek   MeSH
• glukosa aplikace a dávkování   MeSH
• inzulinová rezistence fyziologie   MeSH
• jednotky intenzivní péče MeSH
• kritický stav terapie   MeSH
• kyseliny mastné neesterifikované krev   MeSH
• leptin krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipidy aplikace a dávkování   MeSH
• parenterální výživa úplná metody   MeSH
• prospektivní studie MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• alfa-tokoferol MeSH
• emulze MeSH
• esenciální mastné kyseliny MeSH
• glukosa MeSH
• kyseliny mastné neesterifikované MeSH
• leptin MeSH
• lipidy MeSH