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The Impact of Intravenous Fat Emulsion Administration in Acute Lung Injury
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Journal Article
The Impact of Intravenous Fat Emulsion Administration in Acute Lung Injury
2004
Overview
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(O(2))/FI(O(2)): from 129 +/- 37 to 95 +/- 42), compliance of respiratory system (from 39.2 +/- 12 to 33.1 +/- 9.2 ml/cm H(2)O), and pulmonary vascular resistance (from 258 +/- 47 to 321 +/- 58 dyne x s x cm(-5)). 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.
Publisher
Am Thoracic Soc,American Lung Association,Oxford University Press
Subject
/ Adult
/ Aged
/ Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
/ Biological and medical sciences
/ Bronchoalveolar Lavage Fluid - chemistry
/ Bronchoalveolar Lavage Fluid - cytology
/ Fat Emulsions, Intravenous - adverse effects
/ Fat Emulsions, Intravenous - therapeutic use
/ Female
/ Humans
/ Lung Compliance - drug effects
/ Male
/ Platelet Activating Factor - analysis
/ Pulmonary Circulation - drug effects
/ Pulmonary Gas Exchange - drug effects
/ Respiratory Distress Syndrome, Adult - etiology
/ Respiratory Distress Syndrome, Adult - metabolism
/ Respiratory Distress Syndrome, Adult - mortality
