The impact of intravenous fat emulsion administration in acute lung injury (Journal article)

Lekka, M. E./ Liokatis, S./ Nathanail, C./ Galani, V./ Nakos, G.


The aim of this study was to evaluate the effect of parenteral nutrition containing medium- and long-chain triglycerides on the function of the respiratory system and to investigate mechanisms involved in this process. We studied 13 patients with acute respiratory distress syndrome (ARDS), 8 receiving lipid and 5 placebo, and 6 without ARDS, receiving lipid. Bronchoalveolar lavage (BAL) was performed before and 1 hour after administration of lipid or placebo. In patients with ARDS, lipid administration resulted in deterioration of oxygenation (Pa-O2/Fi(O2): from 129 +/- 37 to 95 +/- 42), compliance of respiratory system (from 39.2 +/- 12 to 33.1 +/- 9.2 ml/cm H2O), and pulmonary vascular resistance (from 258 +/- 47 to 321 +/- 58 dyne.s.cm(-1)). In the BAL fluid of the same group, an increase in total protein and phospholipid concentrations, phospholipase activities, platelet-activating factor and neutrophils, as well as alterations in BAL lipid profile were observed. No significant changes were observed in the control or in the ARDS-Placebo groups. In conclusion, this study indicates that administration of medium- and long-chain triglycerides in patients with ARDS causes alterations in lung function and hemodynamics. Inflammatory cells, possibly activated by lipids, release phospholipase A(2) and platelet-activating factor, enhancing edema formation, inflammation, and surfactant alterations.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Θετικών Επιστημών. Τμήμα Χημείας
Keywords: parenteral nutrition,medium-chain triglycericles/long-chain triglycerides,phospholipase a(2),platelet-activating factor-acetylhydrolase,platelet-activating factor,respiratory-distress-syndrome,platelet-activating-factor,pulmonary surfactant,gas-exchange,intralipid infusion,phospholipases a(2),permeability,proteins,ards,lysophosphatidylcholine
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/9634
ISSN: 1073-449X
Link: <Go to ISI>://000189249300019
http://ajrccm.atsjournals.org/content/169/5/638.full.pdf
Publisher: American Thoracic Society
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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