Improved hemorheological properties during infusion of a lipid emulsion (Intralipid) in healthy subjects.
OBJECTIVE
Lipid emulsions are commonly used for nutrition in critically ill patients. In these patients interventions resulting in deteriorated blood rheology and thereby an impaired microcirculation may be deleterious. This study examined the acute hemorrheological effects of the lipid emulsion Intralipid. We have recently shown that hyperinsulinemia exerts a negative effect on erythrocyte deformability, and here the effect of hyperinsulinemia combined with Intralipid was studied.


METHODS
Eleven healthy subjects received Intralipid (200 mg/ml) intravenously as a bolus injection (0.5 ml/kg) over 10 min and thereafter as a continuous intravenous infusion (90 ml/h) for 4 h combined with heparin (200 U/h) to stimulate lipolysis. During the final 2 h an euglycemic hyperinsulinemic clamp was added. Five subjects underwent the same protocol with the exception that saline was given instead of Intralipid and heparin.


RESULTS
Whole blood viscosity, plasma viscosity, erythrocyte aggregation tendency and fluidity were measured by rotational viscometry. Compared with basal and control values the Intralipid infusion caused greater erythrocyte fluidity (p < 0.05) and less aggregation tendency (p < 0.05). Whole blood and plasma viscosity remained unchanged. Hyperinsulinemia had no significant effect on the hemorrheological variables measured.


CONCLUSIONS
Intralipid has no deleterious effects on blood rheology in healthy subjects. Instead, it leads to improved erythrocyte aggregation tendency and fluidity. If the emulsion exerts the same effects in patients with impaired circulation, the use of Intralipid may be beneficial in these patients.
Linde
T
T
Department of Medical Sciences and Geriatrics, University Hospital, Uppsala, Sweden. Torbjorn.Linde@medicin.uu.se
Sandhagen
B
B
Fugman
A
A
Lithell
H
H
Berne
C
C
Lind
L
L
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D001809:Blood Viscosity / Q000187:drug effects; D004903:Erythrocyte Aggregation / Q000187:drug effects; D004907:Erythrocyte Deformability / Q000187:drug effects; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000494:pharmacology*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D015309:Glucose Clamp Technique; D006400:Hematocrit; D018056:Hemorheology / Q000187:drug effects*; D006801:Humans; D006946:Hyperinsulinism / Q000378:metabolism*; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D007328:Insulin / Q000097:blood; D008066:Lipolysis / Q000187:drug effects; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D012965:Sodium Chloride / Q000494:pharmacology; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D005217:Fat Emulsions, Intravenous; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D014280:Triglycerides; D012965:Sodium Chloride