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The Impact of IV Fat Emulsion Administration in Acute Lung Injury
Author(s) -
Lekka ME,
Liokatis S,
Nathanail C,
Galani V,
Nakos G
Publication year - 2004
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0115426504019005531
Subject(s) - ards , medicine , bronchoalveolar lavage , placebo , respiratory distress , lung , phospholipid , gastroenterology , pharmacology , anesthesia , pathology , biochemistry , chemistry , alternative medicine , membrane
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 (PaO 2 /FI O2 : 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·s·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, and 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.