[Nutritional support in surgery: with special reference to fat emulsion and carnitine]

Energy metabolism of fat emulsion has been studied in rats with various conditions including postoperative catabolism, chronic and acute hepatic dysfunction, diabetes and sepsis. The results indicate that fat emulsion is rapidly eliminated from the blood stream and metabolized readily even in such conditions. Based on these findings, we have actively employed fat emulsion clinically as energy source. In septic rats, it was demonstrated that levels of carnitine decreased and that this decrease was based upon a decrease of synthesis. When carnitine was administrated together with fat emulsion, the energy metabolism returned to approximately normal level. This report also describes the tissue concentrations of carnitine in diabetic rats and the blood and urine concentrations of carnitine in postoperative patients.