title: Gas exchange and pulmonary haemodynamic responses to fat emulsions in acute respiratory distress syndrome.
abstract: OBJECTIVE
  To investigate the gas exchange and pulmonary haemodynamic responses to two different intravenous fat emulsions in patients with acute respiratory distress syndrome (ARDS).
  
  
  METHODS
  Prospective, randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  Intensive care unit in a university-affiliated hospital.
  
  
  METHODS
  21 patients with ARDS [mean age, 57 +/- 3 (SEM) years; Acute Physiology and Chronic Health Evaluation II, 20 +/- 3; Murray's score, 2.85 +/- 0.12] consecutively admitted.
  
  
  METHODS
  Patients were assigned to three groups (n = 7 each): group A (LCT) received long-chain triglycerides (20% LCT), group B (MCT/LCT), medium-chain triglycerides/long-chain triglycerides (20% MCT/LCT: 50/50) and group C placebo (0.9% sodium chloride, NaCl). The infusion was always given at the rate of 2 mg/kg min over a total period of 12 h, with a volume infusion of 500 ml in each group.
  
  
  METHODS
  Data were collected before, immediately after and 12 h after infusion ceased. Pulmonary and systemic haemodynamic and gas exchange variables were measured at each time point. Serum triglyceride cholesterol, and non-esterified fatty acids levels were measured.
  
  
  RESULTS
  During LCT infusion, cardiac output, oxygen consumption and oxygen delivery increased (all p < 0.05), whereas pulmonary haemodynamics, arterial oxygen tension, mixed venous partial pressure of oxygen and venous admixture ratio remained essentially unaltered. No changes were observed following MCT/LCT infusion.
  
  
  CONCLUSIONS
  The administration of LCT emulsion given at a slow rate did not alter arterial oxygenation because of the beneficial effect of a high cardiac output, hence offsetting the detrimental effect of increased O2 consumption.
authors.affiliation: Serveis de Medicina Intensiva, Medicina Preventiva, and Hematologia, Hospital General Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
authors.forename: J R
authors.initials: JR
authors.lastname: Masclans
authors.forename: R
authors.initials: R
authors.lastname: Iglesia
authors.forename: B
authors.initials: B
authors.lastname: Bermejo
authors.forename: M
authors.initials: M
authors.lastname: Picó
authors.forename: R
authors.initials: R
authors.lastname: Rodriguez-Roisin
authors.forename: M
authors.initials: M
authors.lastname: Planas
mesh_terms: D000328:Adult; D000368:Aged; D001784:Blood Gas Analysis; D004311:Double-Blind Method; D005217:Fat Emulsions, Intravenous / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011659:Pulmonary Gas Exchange / Q000187:drug effects*; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000503:physiopathology*; D012720:Severity of Illness Index; D014280:Triglycerides / Q000494:pharmacology*
chemical_list: D005217:Fat Emulsions, Intravenous; D014280:Triglycerides