Effect of fast vs slow intralipid infusion on gas exchange, pulmonary hemodynamics, and prostaglandin metabolism.
Intralipid (20 percent, 500 ml) was infused fast (5 h) or slow (10 h) randomly in patients with lung injury to relate changes in plasma prostaglandin (PG) concentrations to gas exchange and pulmonary hemodynamics. Data were collected at baseline, midpoint of infusion, and 2 h following infusion. Vasodilator and vasoconstrictor PG metabolites, 6-keto-PGF1 alpha, and thromboxane B2, respectively, were measured in radial arterial blood samples. Slow Intralipid infusion increased shunt fraction (QS/QT) without changing mean pulmonary artery pressure (MPAP), whereas fast Intralipid infusion increased MPAP without changing QS/QT. Prostaglandin levels did not change significantly during either infusion. However, in both groups when the PG substrate was removed, hemodynamic and metabolite values decreased in parallel. In conclusion, we were unable to demonstrate a cause and effect relationship between plasma levels of 6-keto-PGF1 alpha and thromboxane B2 and the observed pulmonary hemodynamic response to slow or fast Intralipid infusion.
Mathru
M
M
Loyola University Medical Center, Maywood, IL 60153.
Dries
D J
DJ
Zecca
A
A
Fareed
J
J
Rooney
M W
MW
Rao
T L
TL
D015121:6-Ketoprostaglandin F1 alpha / Q000097:blood*; D001794:Blood Pressure; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D006801:Humans; D011651:Pulmonary Artery / Q000503:physiopathology; D011652:Pulmonary Circulation; D011659:Pulmonary Gas Exchange; D011669:Pulmonary Wedge Pressure; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000503:physiopathology / Q000628:therapy; D013929:Thromboxane B2 / Q000097:blood*
D005217:Fat Emulsions, Intravenous; D013929:Thromboxane B2; D015121:6-Ketoprostaglandin F1 alpha