Intrapulmonary lipid deposits in children treated or not with parenteral nutrition

Background . Reports on pulmonary lipid deposition  after parenteral nutrition (PN) in children were based on small samples. Here we report the prevalence of pulmonary lipid deposition in 114 consecutive autopsied children from a pediatric intensive care unit, including neonates, lactants, preschool, school children and adolescents that used or not PN before death. Methods. All 114 autopsied children (January 1998 through December 2001) from the Intensive Care Unit of the Childrens’s Hospital in Vitoria, ES, Brazil (50 that received PN before death and 64 that did not receive PN). Pulmonary lipid deposit was investigated in frozen sections of two fragments of each lung (peripheral and near the hylus) stained by Oil Red O.  Results. Intrapulmonary lipid deposition was observed in 47% (54/114) of children. PN increased significantly the frequency of pulmonary lipid : 70%(35/50) in the group treated with PN and 29,6% (19/64) in the non-treated group (p=0,000). This difference persists significant if we consider separately the neonates and the children 29 days up to 15 years old (13/22 (59,1%) and 22/28(78,6%) respectively in neonates and in non neonates). Conclusion. Results demonstrated: (a) pulmonary lipid deposits are frequent in children dead at Intensive Care Unit; (b) in the group not treated with PN the frequency of lipid deposits was significantly higher in children older than 28 days than in neonates; (c) parenteral nutrition increased significantly  the risk for pulmonary lipid deposition both in neonates and children older than 28 days. Key words : pulmonary lipid, parenteral nutrition, children