Effect of two lipid emulsions on platelet function.
OBJECTIVE
To examine the effect of two lipid emulsions administered with total parenteral nutrition (TPN) on platelet aggregation and activation and the production of eicosanoids in nonseptic critically ill patients.


METHODS
Prospective, randomized, unblinded, non-crossover study.


METHODS
ICU of a general teaching hospital.


METHODS
23 adult, critically ill, nonseptic patients, who were in need of TPN for at least 7 days.


METHODS
The patients were randomly distributed into 2 groups each of which received TPN with a different essential fatty acid content. The 2 lipid emulsions, Intralipid 20% (long-chain triglycerides) and Lipofundin MCT/LCT 20% (10% each of long- and medium-chain triglycerides) provided 43% of the nonprotein caloric requirements calculated for each patient. Parameters demonstrating platelet function (plasma beta-thromboglobulin, platelet factor 4, platelet aggregation, 6-keto-PGF1 alpha) were assessed before starting TPN and after 4 and 7 days of initiation.


RESULTS
Before beginning lipid perfusion, platelet activation evaluated by beta TG and PF4 levels was notable, 6-keto-PGF1 alpha production was elevated and no hyperaggregation of platelets was observed in patients. The studies of platelet function at 4 and 7 days of TPN did not show significant changes with respect to the basal data or between the 2 groups.


CONCLUSIONS
Our results indicate that platelet function was not affected by either of the 2 lipid emulsions administered to patients during the study period.
Porta
I
I
Santiago Grisolia Metabolic Research Unit, Vall d'Hebron General Teaching Hospital, Barcelona, Spain.
Planas
M
M
Padró
J B
JB
Picó
M
M
Valls
M
M
Schwartz
S
S
D000328:Adult; D001792:Blood Platelets / Q000187:drug effects* / Q000502:physiology; D003422:Critical Care; D004338:Drug Combinations; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D006801:Humans; D010289:Parenteral Nutrition, Total; D010743:Phospholipids / Q000008:administration & dosage*; D015539:Platelet Activation / Q000187:drug effects / Q000502:physiology; D010974:Platelet Aggregation / Q000187:drug effects / Q000502:physiology; D010979:Platelet Function Tests; D011446:Prospective Studies; D013012:Sorbitol / Q000008:administration & dosage*
D004338:Drug Combinations; D005217:Fat Emulsions, Intravenous; D010743:Phospholipids; C008288:Lipofundin; D013012:Sorbitol