Intravenous lipid composition affects hypoxic pulmonary vasoconstriction in the newborn piglet

2001 ◽  
Vol 79 (7) ◽  
pp. 594-600 ◽  
Author(s):  
Keith J Barrington ◽  
George Chan ◽  
John E. Van Aerde
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Output ◽  
Fatty Acid ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Total Parenteral Nutrition ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Plasma Levels ◽  
Lipid Emulsion

To examine the effects of altering the fatty acid (FA) composition of intravenous (IV) lipid emulsions on pulmonary vascular resistance (PVR) and thromboxane production, we studied three groups of newborn piglets after three days of either sow's milk (milk), or total parenteral nutrition (TPN) with either iv soy bean oil (SBO, 52% n-6 and 8% n-3 FA) or fish oil (FO, 5% n-6 and 51% n-3 FA) emulsions. At baseline, and during hypoxia at 20 min and 2 h, cardiac output (Q) was measured, PVR calculated and plasma levels of a prostacyclin metabolite (6-keto-PgF1α) and thromboxane B2 (TxB2) were measured. Fatty acid composition of the lung phospholipids was analyzed. There was an exaggerated increase in PVR and decrease in Q during prolonged hypoxia in the TPN-SBO group as compared with the other two groups. There was no difference in PVR and Q between the milk and TPN-FO groups. FA of lung phospholipids reflected the high dietary level of long chain n-3 FA in the TPN-FO group. However, no differences in plasma levels of 6-keto-PgF1α or TxB2 were found. Intravenous emulsions made from SBO reduced cardiac output and increased pulmonary vascular resistance in the hypoxic newborn piglet, whereas iv FO emulsions did not. When subjects with pulmonary hypertension are receiving TPN iv SBO may be detrimental; iv FO may be beneficial, giving similar responses as in a milk-fed subject.Key words: total parenteral nutrition, fish oil, pulmonary hypertension, lipid emulsion, fatty acids.Key words: total parenteral nutrition, fish oil, pulmonary hypertension, lipid emulsion, fatty acids.

scholarly journals Parenteral fish-oil-based lipid emulsion improves fatty acid profiles and lipids in parenteral nutrition-dependent children

2011 ◽  
Vol 94 (3) ◽  
pp. 749-758 ◽  
Author(s):  
H. D. Le ◽  
V. E. de Meijer ◽  
E. M. Robinson ◽  
D. Zurakowski ◽  
A. K. Potemkin ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Lipid Emulsion ◽  
Fatty Acid Profiles ◽  
Dependent Children

scholarly journals Fish Oil Lipid Emulsion-Associated Sea-Blue Histiocyte Syndrome in a Pediatric Patient

2015 ◽  
Vol 20 (3) ◽  
pp. 217-221
Author(s):  
Ting Ting Wu ◽  
David S. Hoff
Keyword(s):  
Bone Marrow ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Soybean Oil ◽  
Total Parenteral Nutrition ◽  
Pediatric Patient ◽  
Lipid Emulsion

A syndrome of hepatosplenomegaly, thrombocytopenia, and anemia and the presence of sea-blue histiocytes in bone marrow has been associated with parenteral soybean oil administration in patients receiving long-term total parenteral nutrition (TPN). A case is described here where this syndrome was observed in a pediatric patient who received long-term parenteral fish oil nutrition.

Differential Effects of Terlipressin on Pulmonary and Systemic Hemodynamics in Patients With Cirrhosis and Pulmonary Hypertension

Angiology ◽  
2011 ◽  
Vol 63 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Georgios N. Kalambokis ◽  
Konstantinos Pappas ◽  
Epameinondas V. Tsianos
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Output ◽  
Mean Arterial Pressure ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Systemic Hemodynamic ◽  
Hemodynamic Improvement ◽  
Pulmonary Arterial ◽  
Group 2 ◽  
Group 1

Terlipressin has been associated with pulmonary arterial vasodilation in patients with pulmonary hypertension (PH). We investigated the effects of terlipressin on pulmonary vascular resistance (PVR) in patients with cirrhosis without and with PH. Pulmonary vascular resistance and cardiac output (CO) by Doppler ultrasound, mean arterial pressure (MAP), and systemic vascular resistance (SVR) were evaluated in patients with cirrhosis with PVR –120 dyne s cm−5 (group 1, n = 20) and PVR >120 dyne s cm−5 (group 2, n = 10) before and 30 minutes after terlipressin infusion (2 mg). After terlipressin, PVR increased significantly in group 1 (96.1 ± 20.2 vs 85.1 ± 18 dyne s cm−5; P = .004) but decreased significantly in group 2 (170.4 ± 37.8 vs 157.8 ± 28.1 dyne s cm−5; P= .04). Pulmonary vascular resistance changes in group 2 correlated significantly with baseline PVR ( r = −0.632; P = .04). Terlipressin induced a significant increase in MAP and SVR and a significant decrease in CO in both groups. Terlipressin significantly reduces pulmonary pressures in patients with cirrhosis having PH together with systemic hemodynamic improvement.

EXPRESS: Does the use of fish-oil based lipid emulsion in the clinical setting of total parenteral nutrition (TPN) and lipid rescue therapy interfere with common laboratory analytes on Roche Cobas 6000?

2020 ◽  
pp. 000456322098659
Author(s):  
Jun Guan Tan ◽  
Moh Sim Wong
Keyword(s):  
Parenteral Nutrition ◽  
Fish Oil ◽  
Total Parenteral Nutrition ◽  
Clinical Setting ◽  
High Speed ◽  
Lipid Emulsion ◽  
Rescue Therapy ◽  
Lipid Rescue ◽  
State Concentration ◽  
Roche Cobas

Background Lipaemic interference on automated analysers has been widely studied using soy-based emulsion such as Intralipid. Due to the greater adoption of fish oil-based lipid emulsion for total parenteral nutrition in view of improved clinical outcomes, we seek to characterize the optical properties of SMOFLipid 20%(Fresenius Kabi, Bad Homburg, Germany), a fish-oil based emulsion, on the Roche Cobas 6000 chemistry analyser(Roche Diagnostic, Basel, Switzerland). Method Various amounts of SMOFlipid were spiked into pooled seras. We plotted Roche Cobas Serum Indices Lipaemic indices(L-index) against the amount of SMOFlipid added. We then studied the interference thresholds for AST, ALT, Albumin and renal panel analytes using SMOFlipid. We subjected five levels of spiked lipaemia to high speed centrifugation and analysed the specimens pre and post centrifugation. To postulate whether fish-oil based lipid emulsion interferes with laboratory results in the clinical setting, we calculated concentrations of SMOFlipid post lipid rescue therapy and steady state concentration of a typical TPN regime using pharmacokinetic principles. Results SMOFlipid optical behaviour is similar to Intralipid using the Serum indices L-index, with 1mg/dL of SMOFlipid representing 1 unit of L-index. Manufacturer stated interference thresholds are accurate for ALT, AST, albumin, urea and creatinine. High speed centrifugation at 60 min 21100G facilitates the removal of fish-oil based SMOFlipid. Conclusion Based on the interference thresholds we verified and pharmacokinetics parameters provided by SMOFlipid manufacturer, total parenteral nutrition may not interfere with chemistry analytes given sufficient clearance, but lipid rescue therapy will interfere. Further studies assessing lipaemic interference on immunoassays are needed

High Cardiac Output By Microfistulas: A New Pulmonary Hypertension Mechanism in Patients with Myelofibrosis and the Impact of the Treatment with Ruxolitinib

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4065-4065
Author(s):  
Jose Maria Segovia ◽  
Emilio Ojeda ◽  
Gomez-Bueno Manuel Francisco ◽  
Rafael Fores ◽  
Jose A Garcia-Marco ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Output ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
High Cardiac Output ◽  
Advanced Phase ◽  
The Impact

Abstract Background: Pulmonary Hypertension (PH) is a well-known complication of the advanced phase of Myeloproliferative Diseases (MPD) such as Polycythemia Vera (PV), Essential Thrombocytopenia (ET) and Myelofibrosis (MF). Although initially attributed to increased pulmonary vascular resistance (group 1 PH of the WHO classification), this entity was classified in 2009 in group 5 PH (unknown mechanism and miscellaneous PH). Our aim was to describe the prevalence and possible causes of PH in a series of patients with MF. Methods: We studied a series of patients with Primary MF or Secondary MF to other MPD with cardiac ultrasound, right heart catheterization and scintigraphy after intraarterial infusion of Tc99-labeled albumin macroaggregates. Results: We studied 11 consecutive patients with MF (7 male, mean age 58 years, 4 with MF post-PV, 4 post-TE and 3 Primary MF) during the period 2009-2014. All of them had mutations of JAK-2 gene, fibrosis in bone marrow biopsy and visceromegaly (all with intermediate-2 or higher IPSS). Median NTproBNP levels were 4597 pg/ml (range 175-5700). Echocardiogram showed high systolic pulmonary pressure in most cases, with a mean of 54 ± 17 mmHg (range 35-80). Right heart catheterization showed high cardiac output (HCO) in all patients (table 1). After ruling out other causes of HCO, a scintigraphy was performed after administration of Tc99-labeled albumin macroaggregates in descending thoracic aorta. In every case, a percentage of the labeled macroaggregates (6.1 ± 2.0% of the radioactivity) were plugged in the pulmonary capillary bed, what is diagnostic of the presence of microfistulas in infradiaphragmatic territory. In two of these patients, scintigraphies were performed at diagnosis and after been treated with the anti-JAK drug Ruxolitinib (Novartis Pharma). A favourable impact of this drug was obtained in the two cases, probably due to a reduction of spleen volume. Conclusion: Most patients with MF show pulmonary hypertension associated with high cardiac output caused by microfistulas, without significant increase in pulmonary resistance. This finding has important clinical implications, because pulmonary vasodilators (once recommended) should be contraindicated, since they could cause worsening of the clinical picture. Ruxolitinib could resolve PH in MF and a prospective study in this sense could be indicated. Table 1. Patient 1 2 3 4 5 6 7 8 9 10 11 Pulmonary Artery Pres. (S/D/Mean) 58/38/ 42 69/41/ 50 48/29/ 40 84/26/ 45 57/17/ 30 22/17 / 19 51/16 / 28 22/9 / 13 25/8 / 14 71/23 / 39 30/7 / 15 Pulmonary wedge pres. 28 37 27 13 9 7 13 7 8 12 6 Cardiac output (l/min) 12.5 8.0 11 7.1 8 7.3 8.7 6.7 7.45 6 7.8 Cardiac index (l/m/m2) 5.5 4.0 6.6 3.6 5 4 4.8 4.0 4.5 3.9 5.1 Pulmonary vascular resistance (Wood U.) 1.2 1.4 1.2 4.5 2.6 3 1.7 0.9 0.8 4.5 1.1 Disclosures Ojeda: Alexion Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Fores:Alexion Pharmaceuticals: Consultancy, Speakers Bureau.

Tissue fatty acid (FA) pattern during fish oil supplemented total parenteral nutrition (TPN) in dogs

1992 ◽  
Vol 11 ◽  
pp. 46-47 ◽  
Author(s):  
C. Simoens ◽  
C. Rössle ◽  
M. Richelle ◽  
V. Crabbe ◽  
M. Derluyn ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Total Parenteral Nutrition ◽  
Tissue Fatty Acid
Sign in / Sign up

Export Citation Format

Share Document