Rate of elimination of the Intralipid fat emulsion from the circulation in ICU patients

Lindholm, Marianne; Rössner, Stephan

doi:10.1097/00003246-198211000-00008

Cited by 47 publications

(7 citation statements)

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“…The rate of removal of soyabean fat (Intralipid) is governed by a first order reaction in the range 5-10 % min" 1 [19]. Even at an infusion rate of up to 25 g h" 1 in a 70-kg adult, it does not exceed the elimination limits [20], therefore a constant blood concentration may be assumed in this study. The partition coefficient was measured separately before and after administration of propofol in three patients, and was unchanged.…”

Section: Discussionmentioning

confidence: 99%

Is the End-Tidal Partial Pressure of Isoflurane a Good Predictor of Its Arterial Partial Pressure?

Frei

Zbinden

Thomson

et al. 1991

British Journal of Anaesthesia

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End-tidal partial pressure of isoflurane (PE'iso) may be used as a measure of anaesthetic depth. During uptake, an arterial partial pressure (Paiso) which is considerably less than PE'iso (Paiso/PE'iso much less than 1) leads to underestimation of depth of anaesthesia and, during elimination, PE'iso/Paiso much less than 1 will lead to an overestimation of anaesthetic depth. We measured Paiso/PE'iso during a 60-min uptake period of 1% isoflurane and PE'iso/Paiso during the subsequent 60-min elimination period in 26 patients (age 13-88 yr, ASA I-III) undergoing various surgical procedures. After 15 min of isoflurane uptake, Paiso/PE'iso of 26 patients was mean 0.78 (SD 0.10) and this increased only marginally at 60 min (0.79 (0.09)), whereas during elimination, PE'iso/Paiso was in the range 0.79 (0.14)-0.83 (0.11). Predictability of Paiso in a given patient is hindered by the high SD of Paiso/PE'iso and PE'iso/Paiso, but it may be improved by taking into account age, ASA physical status category, vital capacity, inspired minus end-tidal isoflurane partial pressure and arterial minus end-tidal carbon dioxide partial pressure during uptake; and obesity, end-tidal isoflurane partial pressure and arterial minus end-tidal carbon dioxide partial pressure during elimination. However, even with multiple regression analysis (to account for the various possible variables), clinically useful prediction of Paiso/PE'iso and PE'iso/Paiso in a particular patient is not possible (residual SD 0.084 and 0.113, respectively).

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Section: Discussionmentioning

confidence: 99%

Is the End-Tidal Partial Pressure of Isoflurane a Good Predictor of Its Arterial Partial Pressure?

Frei

Zbinden

Thomson

et al. 1991

British Journal of Anaesthesia

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“…However, recent studies have dispelled the issues of liver toxicity, fat overload syndrome, and rapid clearance. 13,14,15 Our histological examination of lung tissue failed to demonstrate evidence of fat embolization at 24 hours after resuscitation with LM. The representative H&E sections in Figure 4 demonstrate the remarkable similarity in lung parenchyma we observed for mice resuscitated with LM or shed blood.…”

Section: Discussionmentioning

confidence: 67%

Soybean oil: a potentially new intravascular perfusate

et al. 2012

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(1) Soybean oil emulsions were superior to other fluids in restoring and maintaining the blood pressure; (2) oxygen-carrying ability of soybean oil micelles exceeds that of water and follows Henry's law between 10% and 30% w/v oil content; (3) nitric oxide was carried by the micelles; (4) animals receiving soybean oil micelles did not exhibit fat embolization; (5) colloids comprised of soybean oil-containing micelles may be used to replace blood loss and may be used to deliver oxygen and other potentially therapeutic gases such as nitric oxide to tissues.

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“…The significance of this impaired function becomes evident from the work of Braun et al, who found an inspiratory vacuum less than 30% of normal commonly resulted in hypercapnic respiratory failure and ventilatory dependency in patients with polymyositis and other proximal myopathies.5 A study conducted in 1944, the Minnesota experiment, evaluated pulmonary function, among other things, in 32 healthy men who were conscientious objectors to the war effort. Studies were conducted before and after 24 weeks of semistarvation (average of 1500 kcal/d) and then after a 12-week period of refeeding.6 Vital capacity, tidal volume, and, most importantly, minute ventilation decreased by 8%, 19%, and 31%, respectively (Table 1). Finally, at Duke University, we evaluated maximal expiratory pressures and maximal inspiratory vacuums in 21 malnourished, nonstressed patients and demonstrated only 59% of predicted maximal expiratory pressures and 43% of maximal inspiratory vacuums ( al demonstrated a blunted ventilatory response to breathing 2% and 4% carbon dioxide in inspired air after a 7-day protein-free diet.8 There was also a 26% reduction in ventilation and mean inspiratory flow rate, an index of neural ventilatory drive.…”

Section: Effect Of Malnutrition On Pulmonary Functionmentioning

confidence: 99%

Invited Review: Nutrition Care of Patients With Acute and Chronic Respiratory Failure

Grant

1994

Nut in Clin Prac

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Nutrition is intimately linked to pulmonary function and an understanding of these relationships have therapeutic utility. Malnutrition is known to be associated with impaired mechanical function of the lung in both chronic and acute respiratory insufficiency. Refeeding results in improvement in functional characteristics and may be critical in the weaning of patients from mechanical ventilation. In contrast, overfeeding may result in an increased ventilatory demand resulting in the inability to wean from respiratory support. This article considers the background as well as recommendations for the nutritional care of patients with acute and chronic respiratory failure.

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Rate of elimination of the Intralipid fat emulsion from the circulation in ICU patients

Cited by 47 publications

References 0 publications

Is the End-Tidal Partial Pressure of Isoflurane a Good Predictor of Its Arterial Partial Pressure?

Is the End-Tidal Partial Pressure of Isoflurane a Good Predictor of Its Arterial Partial Pressure?

Soybean oil: a potentially new intravascular perfusate

Invited Review: Nutrition Care of Patients With Acute and Chronic Respiratory Failure

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