Effect of Fast vs Slow Intralipid Infusion on Gas Exchange, Pulmonary Hemodynamics, and Prostaglandin Metabolism

Parenteral Beslenen Yoğun Bakım Hastalarında Soya Yağı, Zeytinyağı ve Mct-Lct Bazlı Nutrisyon Solüsyonlarının Etkilerinin Karşılaştırılması

“…Soya yağı kaynaklı Omega-6 yağ asitleri özellikle Akut Respiratuar Distres Sendromu (ARDS) olan kritik hastalarda proinflamatuar etkiye ve zararlı potansiyele sahip olabilmektedirler (10,11). Bu nedenle, Omega-6 yağ asitlerinin anti-inflamatuar etkili, balık yağı kaynaklı Omega-3 yağ asitleri, zeytinyağı kaynaklı Omega-9 yağ asitleri veya orta zincirli yağ asitleri (MCT) ile kombine edilmesi proinflamatuvar etkinin sınırlandırılmasında yararlı olabilir (12)(13)(14)(15)(16)(17).…”

Intravenous fat emulsion: A potential novel antidote

“…Initial case series showed that IFE resulted in lowered blood oxygen content, increased shunting, and pulmonary vasoconstriction when given to patients with respiratory failure and/or sepsis [15,16]. Subsequent clinical series identified patients with adult respiratory distress syndrome (ARDS) as having increased risk of pulmonary effects [17,18]. Patients with normal lung function or with pulmonary compromise but no ARDS did not demonstrate lowered oxygenation or pulmonary vascular changes [5,17].…”

“…Patients with normal lung function or with pulmonary compromise but no ARDS did not demonstrate lowered oxygenation or pulmonary vascular changes [5,17]. In all 5 reports, the abnormal physiology was transient and returned to baseline after completion of IFE [15][16][17][18]. An investigation using an in-vivo rabbit model demonstrated that there must be pre-existing lung injury in order to induce lipid emulsion physiological changes [19].…”

Lipid rescue: the use of lipid emulsions to treat local anaesthetic toxicity

“…If the globules exceed 5 μm in diameter, splenic, cerebral or pulmonary emboli and pulmonary hypertension can occur. 53 Even rapid administration of large doses of stable lipid emulsion can have potential side-effects, which may be aggravated by the presence of high plasma levels of local anaesthetic agents. Local anaesthetics induce myocardial depression, even at levels found in normal clinical use.…”

“…Local anaesthetics induce myocardial depression, even at levels found in normal clinical use. 14,16,18 Myocardial depression will be aggravated by increases in both right 53 and left ventricular afterload that are associated with both lipid emulsion therapy and local anaesthetic toxicity. Local anaesthetic toxicity increases centrally mediated sympathetic nervous system outflow, thereby increasing left ventricular afterload.…”