Long term lipid-based parenteral nutrition causes pulmonary hypertension in pigs.
OBJECTIVE
To study pulmonary perfusion after long term intravenous lipid-based total parenteral nutrition (TPN).


METHODS
Open experimental study.


METHODS
Teaching hospital, Norway.


METHODS
31 pigs.


METHODS
Infusion of TPN alone, TPN + pellets, or Ringer's solution alone through central venous catheters for 7 weeks.


METHODS
Haemodynamic variables during a standardised volume load, and measurement of plasma N-terminal pro-atrial natriuretic factor (ANF).


RESULTS
Mean pulmonary artery pressure (PAP) was 12.9 (6.1) to 20.1 (3.0) mmHg in response to the volume load in control animals compared with 15.8 (8.5) to 25.4 (5.8) (p < 0.05) mmHg in those given TPN alone and 22.8 (10.3) (p < 0.05) to 28.0 (6.4) (p < 0.05) mmHg in those given TPN and pellets. Pulmonary vascular resistance index was also increased after TPN, but the plasma N-terminal pro-ANF concentration did not increase during infusion of TPN.


CONCLUSIONS
Long term TPN caused moderate pulmonary hypertension, but not longstanding right-sided congestion.
Aksnes
J
J
Institute for Surgical Research, National Hospital, University of Oslo, Norway.
Schmidt
H
H
Hall
C
C
Nordstrand
K
K
D000818:Animals; D009320:Atrial Natriuretic Factor / Q000097:blood; D002405:Catheterization, Central Venous; D002496:Central Venous Pressure; D002149:Energy Intake; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000503:physiopathology; D019787:Linoleic Acid; D008041:Linoleic Acids / Q000009:adverse effects; D009318:Natriuresis; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D011498:Protein Precursors / Q000097:blood; D011669:Pulmonary Wedge Pressure; D013552:Swine; D013997:Time Factors
D005217:Fat Emulsions, Intravenous; D008041:Linoleic Acids; D011498:Protein Precursors; D009320:Atrial Natriuretic Factor; D019787:Linoleic Acid