title: Fat emulsion infusion potentiates coagulation activation during human endotoxemia.
abstract: Intravenous fat emulsions are frequently given to malnourished patients who are prone to suffer from infectious complications. As injection of low dose endotoxin represents a model to study the human response to acute infection, we sought to determine the effect of lipid emulsion infusion on endotoxin-induced activation of the hemostatic mechanism in man. Ten healthy men received a bolus intravenous injection of endotoxin (lot EC-5; 20 U/kg) midway through a 4-h infusion (125 ml/h) of either dextrose 5% (n = 5) or Intralipid 20% (n = 5). Lipid infusion potentiated endotoxin-induced coagulation activation, as indicated by higher plasma levels of the prothrombin fragment F1 + 2 and of thrombin-antithrombin III complexes (both p < 0.05 for the difference between groups). However, lipid infusion did not influence the fibrinolytic response to intravenous endotoxin, as reflected by similar increases in the levels of tissue-type plasminogen activator and plasmin-alpha 2-antiplasmin complexes in both groups. Endotoxin-induced appearance of plasminogen activator inhibitor type I was enhanced by lipid infusion (p < 0.05). These data suggest that fat emulsion infusion may enhance the tendency towards thrombotic complications in patients with infections.
authors.affiliation: Laboratory of Surgical Metabolism, Cornell University Medical College, New York, NY 10021, USA.
authors.forename: T
authors.initials: T
authors.lastname: van der Poll
authors.forename: S M
authors.initials: SM
authors.lastname: Coyle
authors.forename: M
authors.initials: M
authors.lastname: Levi
authors.forename: M A
authors.initials: MA
authors.lastname: Boermeester
authors.forename: C C
authors.initials: CC
authors.lastname: Braxton
authors.forename: P M
authors.initials: PM
authors.lastname: Jansen
authors.forename: C E
authors.initials: CE
authors.lastname: Hack
authors.forename: S F
authors.initials: SF
authors.lastname: Lowry
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000628:therapy*; D001777:Blood Coagulation / Q000187:drug effects*; D004731:Endotoxins / Q000097:blood*; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D008297:Male
chemical_list: D004731:Endotoxins; D005217:Fat Emulsions, Intravenous