Intralipid alterations in pulmonary prostaglandin metabolism and gas exchange

Hageman, Joseph R; McCulloch, Kristine M.; Gora, Paul; Olsen, Eric; Pachman, Lauren M.; Hunt, Carl E.

doi:10.1097/00003246-198310000-00006

Cited by 75 publications

(22 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These differences may be important because a major contribution to the gas exchange effects of intravenous fat use is attributed to the increased production of prostaglandins (thromboxane A 2 , prostacyclin) [32][33][34] since fat emulsions provide precursors of prostaglandins [35].…”

Section: Pulmonary Hemodynamics and Gas Exchangementioning

confidence: 99%

Lipid Emulsions in Parenteral Nutrition

Adolph

1999

Ann Nutr Metab

View full text Add to dashboard Cite

Lipid emulsions containing a physical mixture of medium and long chain triglycerides (MCT/LCT) are a well-proven concept in parenteral nutrition of critically ill patients. Having a demonstrably higher utilization rate, MCT/LCT emulsions do not impair liver function, produce less immune and no reticuloendothelial system function compromise, and do not interfere with pulmonary hemodynamics or gas exchange. A reduced content of n–6 polyunsaturated fatty acids can also be obtained by using newer preparations based on structured triglycerides or olive oil. Further studies are necessary in order to investigate these new lipid emulsions versus the physical mixture of MCT/LCT. A promising substrate in the development of lipid emulsions can be seen in fish oils. With regard to current literature, fish oils have a beneficial influence on the pathophysiological response to endotoxins and exert important modulations on eicosanoid and cytokine biology. Furthermore their intravenous use may improve organ perfusion in different critical situations.

show abstract

Section: Pulmonary Hemodynamics and Gas Exchangementioning

confidence: 99%

Lipid Emulsions in Parenteral Nutrition

Adolph

1999

Ann Nutr Metab

View full text Add to dashboard Cite

show abstract

“…conflicting results. A significant decrease in PaC>2 was observed in the awake sheep [8], while in rabbits oxygenation was only im paired when lipid infusion was adminis tered to oleic acid lung-damaged animals [7], In adults, Greene et al [6] reported a decrease in PaC>2 in contrast to Sundstrom et al [5], who observed a significant in crease in oxygenation during lipid adminis tration.…”

Section: Resultsmentioning

confidence: 98%

Intralipid-Induced Decrease in Oxygenation in Neonates Is Related to Changes in the Respiratory Quotient

Tay-Uyboco

Belik²

1990

Dev Pharmacol Ther

View full text Add to dashboard Cite

Intravenous lipid infusion has been previously reported to be associated with hypoxemia. Different mechanisms have been proposed, but none have explored the decrease in respiratory quotient (RQ) following lipid administration as a possible factor. Ten neonates without respiratory problems, breathing room air and on total parenteral nutrition were studied. Arterialized capillary blood gases, transcutaneous PO(2) (TcPO(2)) measurements and expired gas concentrations were obtained, prior to and 1 g/kg of 10% lipid emulsion was infused over 6 h. Following lipid infusion, the TCPO(2) decreased from 72 ± 8 to 65 ± 8 mm Hg and the RQ decreased from 0.94 ± 0.08 to 0.86 ± 0.5 (p < 0.05), while the pH, PaCO(2) and the alveolar-arterial oxygen tension difference did not change. The decrease in TcPO(2) significantly correlated with the decrease in alveolar oxygen tension. Seven of the 10 infants had a significant decrease in TCPO(2) with a significant decrease in RQ from 0.98 ± 0.05 to 0.85 ± 0.06 (p < 0.01). In 3 patients with no significant change in TcPO(2) following intralipid administration, the RQ was initially significantly lower than the rest of the group (0.85 ± 0.04; p < 0.05) and did not change at the end of the infusion (0.88 ± 0.03). These data suggest that the changes in PaCO(2) following lipid infusion in neonates without lung disease and breathing room air, are related to the decrease in alveolar oxygen tension secondary to the change in RQ.

show abstract

“…Lipid emulsion-induced pulmonary gas exchange disturbances can vary due to several factors, namely the different amounts of prostanoid precursors administered [4,8,10,13,14], the rate and duration of the lipid perfusion, and/or the pre-existing pathophysiological status of the lung [9,12].…”

Section: Discussionmentioning

confidence: 99%

“…The association of heparin with lipid infusions clears the serum of triglycerides but does not influence the increments of pulmonary artery pressure nor the decreased arterial oxygen tension (PaO2) induced by the intravenous administration of fat emulsions [2,3]. The latter effects are, however, prevented with indomethacin, a prostaglandin inhibitor, hence suggesting that lipid-induced alterations in pulmonary vasomotor tone could be associated with the excessive release of arachidonic acid-derived mediators [3,4].…”

Section: Introductionmentioning

confidence: 99%