Neonatal parenteral nutrition with medium-chain triglycerides: rationale for research

With the advances in technology stable fat emulsions containing medium-chain triglycerides (MCT) became available. Intravenous MCT are readily utilizable energy source because they reach the liver rapidly and their medium-chain fatty acids (MCFA) are oxidized through carnitine-independent mechanisms. However the MCFA can also be deviated to alternative oxidation pathways which results in urinary excretion of metabolites. The metabolic effects of intravenous MCT containing fat emulsions are discussed and emphasis is given in the possible role of these fats in parenteral nutrition of preterm infants, who are carnitine depleted. Directions of future research are speculated.