title: Effects of Intralipid infusion on hemorheology and peripheral resistance in neonates and children.
abstract: Deleterious microcirculatory effects of Intralipid (IL) infusion may be caused by hemorheological or vascular effects. The aim of this investigation was to study vascular and hemorheological effects of IL in preterm and fullterm neonates and children. Ten preterm newborns, 10 fullterm neonates, and 10 children received an initial infusion of IL (0.6 g/kg) over 4 h. Calf blood flow (venous occlusion plethysmography), blood pressure (Dinamap), whole blood and plasma viscosity (capillary viscometer), red blood cell deformability (rheoscope), and erythrocyte aggregation (aggregometer) were measured before and after administration of IL. Plasma triglyceride levels showed the greatest increase in preterm infants. Whole blood viscosity decreased by about 10% in all three groups because of a similar reduction in hematocrit. Red blood cell aggregation decreased by about 20% after IL infusion. Blood pressure rose by 10%, and peripheral blood flow declined by about 10% in the three groups. Vascular hindrance, a calculation of blood pressure divided by blood flow and viscosity, was raised by about 20%, suggesting marked vasoconstriction of peripheral arteries. Vasoconstriction rather than hemorheological changes during infusion of IL may play a crucial role in the pathogenesis of circulatory alterations in parenterally-fed neonates.
authors.affiliation: Department of Surgical Pediatrics, University of Bern Inselspital, 3010 Bern, Switzerland. ulf.kessler@insel.ch
authors.forename: Ulf
authors.initials: U
authors.lastname: Kessler
authors.forename: Zacharias
authors.initials: Z
authors.lastname: Zachariou
authors.forename: Dorothea
authors.initials: D
authors.lastname: Raz
authors.forename: Johannes
authors.initials: J
authors.lastname: Poeschl
authors.forename: Otwin
authors.initials: O
authors.lastname: Linderkamp
mesh_terms: D000367:Age Factors; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001798:Blood Proteins / Q000378:metabolism; D001809:Blood Viscosity / Q000187:drug effects / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004903:Erythrocyte Aggregation / Q000187:drug effects / Q000502:physiology; D004907:Erythrocyte Deformability; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage*; D006400:Hematocrit; D018056:Hemorheology / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D010991:Plethysmography; D014655:Vascular Resistance / Q000187:drug effects / Q000502:physiology*; D014661:Vasoconstriction / Q000187:drug effects / Q000502:physiology
chemical_list: D001798:Blood Proteins; D005217:Fat Emulsions, Intravenous