Pulmonary vascular resistance during lipid infusion in neonates.
Using two-dimensional echocardiography, pulmonary vascular resistance was estimated from right ventricular pre-ejection period to ejection time (RVPEP/ET) in 11 preterm infants with respiratory distress, to test the effect of different doses of continuous lipid infusion. Echocardiography was performed at baseline with no lipid infusing 2 and 24 hours after 1.5 and 3 g/kg/day of intravenous lipid, 24 hours after discontinuing intravenous lipid emulsion, and 2 hours after restarting intravenous lipid. After 24 hours of intravenous lipid at 1.5 g/kg/day the RVPEP/ET rose to mean (SD) 0.287 (0.03) from a baseline value of 0.225 (0.02) and to 0.326 (0.05) after 24 hours of intravenous lipid at 3 g/kg/day. Pulmonary arterial pressure returned to baseline 24 hours after the intravenous lipid had been discontinued. Continuous 24 hour infusion of lipid caused significant dose and time-dependent increases in pulmonary vascular resistance. Intravenous lipid may aggravate pulmonary hypertension.
Prasertsom
W
W
Division of Newborn Medicine, Children's Health Centre, University of Alberta, Edmonton, Canada.
Phillipos
E Z
EZ
Van Aerde
J E
JE
Robertson
M
M
D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000098:blood supply*; D010289:Parenteral Nutrition, Total; D011667:Pulmonary Veins / Q000187:drug effects; D012127:Respiratory Distress Syndrome, Newborn / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014655:Vascular Resistance / Q000187:drug effects*
D005217:Fat Emulsions, Intravenous