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).
Design
Prospective, randomized, double-blind, placebo-controlled study.
Setting
Intensive care unit in a university-affiliated hospital.
Patients
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.
Interventions
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.
Measurements
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.
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Supported by the DGICYT (Dirección General de Investigación Científica y Técnica) (PM 91-0055), and the Comissionat per a Universitats i Recerca (1997-SGR 00086) from the Generalität de Catalunya
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Masclans, J.R., Iglesia, R., Bermejo, B. et al. Gas exchange and pulmonary haemodynamic responses to fat emulsions in acute respiratory distress syndrome. Intensive Care Med 24, 918–923 (1998). https://doi.org/10.1007/s001340050690
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DOI: https://doi.org/10.1007/s001340050690