Lipofundin(R) MCT/LCT 20% increase left ventricular systolic pressure in an ex vivo rat heart model via increase of intracellular calcium level / 대한마취과학회지

BACKGROUND: Lipid emulsions have been used to treat various drug toxicities and for total parenteral nutrition therapy. Their usefulness has also been confirmed in patients with local anesthetic-induced cardiac toxicity. The purpose of this study was to measure the hemodynamic and composition effects of lipid emulsions and to elucidate the mechanism associated with changes in intracellular calcium levels in myocardiocytes. METHODS: We measured hemodynamic effects using a digital analysis system after Intralipid(R) and Lipofundin(R) MCT/LCT were infused into hearts hanging in a Langendorff perfusion system. We measured the effects of the lipid emulsions on intracellular calcium levels in H9c2 cells by confocal microscopy. RESULTS: Infusion of Lipofundin(R) MCT/LCT 20% (1 ml/kg) resulted in a significant increase in left ventricular systolic pressure compared to that after infusing modified Krebs-Henseleit solution (1 ml/kg) (P = 0.003, 95% confidence interval [CI], 2.4-12.5). Lipofundin(R) MCT/LCT 20% had a more positive inotropic effect than that of Intralipid(R) 20% (P = 0.009, 95% CI, 1.4-11.6). Both lipid emulsion treatments increased intracellular calcium levels. Lipofundin(R) MCT/LCT (0.01%) increased intracellular calcium level more than that of 0.01% Intralipid(R) (P < 0.05, 95% CI, 0.0-1.9). CONCLUSIONS: These two lipid emulsions had different inotropic effects depending on their triglyceride component. The inotropic effect of lipid emulsions could be related with intracellular calcium level.

Impact of fish oil on complications and inflammatory mediators in patients at nutritional risk after major abdominal surgery / 中华临床营养杂志

Objective To explore the change of complications and inflammatory mediators in patients at nutritional risk after intervention with fish oil after major abdominal surgery.Methods Totally 60 patients who had received extrahepatic bile duct exploration ± left lobectomy and radical surgeries for their gastrointestinal tumors in our department from September 2010 to March 2011 were enrolled in this study.Their Nutritional Risk Screening 2002 scores were ≥3 points the day after surgery.These 60 cases patients were randomly divided into fish oil group (n =30) and the control group (n =30).Both groups were treated with total parenteral nutrition isocaloric and isonitrogenous energy emulsion intralipid of 3 Ls' bags after surgery.Aslo,they were treated with electrolyte,vitamins and trace elements equally,which were adjusted according to laboratory tests.The application of parenteral nutrition was no less than 5 days,and the other treatment was provided routinely.Surgeries were performed under general anesthesia in all patients.Urinary catheter was uniformly placed preoperative,and was removed within 24 hours after surgery.The degree of surgical trauma was scored on the operative day.Fasting venous blood samples were collected for measuring the fasting interleukin (IL)-6 and tumour necrosis factor-α (TNF-α) one day before surgery and one and six days after surgery.The relevant complications were recorded.Two patients in the fish oil group withdrew from the study on the third post-operative day.Results TheIL-6 levels were (10.65 ± 4.24),(29.45 ± 9.39),and (13.37 ± 6.99) ng/Land the TNF-α levels were (2.47 ± 1.16),(23.05 ± 11.43),and (6.05 ± 2.97) ng/L in the fish oil group one day before surgery and one and six days after surgery.In the control group,in contrast,the IL-6 levels were (11.17 ± 4.67),(25.10 ± 10.13),and (17.38 ± 7.13) ng/L and the TNF-α levels were (2.70 ± 1.63),(22.11 ± 12.54),and (8.93 ± 3.61) ng/L at the corresponding time points.Comparisons of the IL-6 and TNF-α between the fish oil group and control group showed no significant difference one day before surgery and one day after surgery (P =0.787,P =0.206,P =0.983,P =0.852).Comparison of the IL-6 between the one day and six days after surgery also had no statistical significance (P =0.101).However,the decrease of IL-6 was significantly larger in the fish oil group than in the control group from day 1 to day 6 after surgery (P =0.036).The post-operative levels of TNF-α were significantly different between these two groups (P =0.024).Complications were noted in 3 cases (2 cases of infectious complications) in the fish oil group and in 6 cases in the control group (5 cases of infectious complications) (P =0.002),in which the inffectious complications were also statistically significant (P =0.001).Conclusions Patients at nutritional risks after major abdominal surgeries have higher TNF-α and IL-6 levels.Fish oil can notably reduce the TNF-α level in these patients.In addition,fish oil decreases the surgical complications,in particular the infectious complications.

Protective effect of intralipid on myocardium in extracorporeal circulation of cardiac valve replacement / 第二军医大学学报

Objective To investigate the effect of intralipid postconditioning on myocardial enzyme in patients receiving extracorporeal circulation of cardiac valve replacement. Methods Forty patients undergoing cardiac valve replacement were randomly divided into two groups. Patients in the experimental group were given intralipid (200 mL) immediately after aorta opening from the extracorporeal circulation machine, and those in the control group were given 200 mL normal saline in the same manner. The radial artery blood samples were collected at the beginning of the operation, 0. 5 h, 1 h, 2 h, 4 h, and 24 h after aorta opening. The serum lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and cardiac troponin I (cTni) were observed and the blood gas analysis was performed. The hemodynamic parameters, time of cardiopulmonary bypass, time of aorta block, time of operation, recovery of heartbeat, the dosage of dopamine, assisted ventilation time, ICU detention time, 24 h urine amount, and 24 hour drainage amount after operation were all recorded in the two groups. Results There were no significant differences in hemodynamic parameters, dosage of dopamine used, spontaneous recovery of heartbeat, 24 h urine amount, or 24 hour drainage amount between the two groups CP>O. 05). The postoperative levels of serum LDH, CK, CK-MB, and cTni were significantly higher than those before operation in both groups CP

Investigation of rat osteoporosis resulting from hyperlipidemia / 中国临床药理学与治疗学

AIM: To establish the hyperlipemic rat model by long-term gastric perfusion of intralipid and investigate the effects of hyperlipidemia on bone. METHODS: Eighteen SD rats were randomly divided into control group (C) and high-fat-diet group (HDF), with 9 rats per group. Rats of C group were treated orally with normal saline, and rats in HDF group were oral gavage of intralipid at dose of 5.0 mL/kg, once a day for 20 weeks. At the end of experiment, their serum levels of lipid were measured. Bone histomorphometric analysis of thighbone was performed in undecalcified sections, and the length and width of ulnar were measured. RESULTS: Compared with the C group, serum TC and low density lipoproteins (LDL) were increased (P

Intralipid Infusions Effect on Nutrophil Elastase Level in Newborns

PURPOSE: Parenteral nutrition is given to infants who tempararily cannot take oral feeding adequately. A lipid emulsion is added to the parenteral to supply essential fatty acids. In neonatal sepsis, elastase from azuropilic granules of the neutrophils is released and rapidly bound to alpha1-Proteinase Inhibitor(alpha1-PI). The lipid emulsion has been noted to markedly inhibit chemotaxis of neutrophils, so we to measured the levels of Elastase-alpha1-Proteinase Inhibitor(E-alpha1-PI) complex to evaluate the effect of intralipid infusions on the neutrophil in newborns with sepsis. METHODS: This study evaluated 8 patients with neonatal sepsis and 12 normal newborns. We measured E-alpha1-PI complex levels in the serum of these patients by ELISA methods. RESULTS: Before infusion with lipid solution, patients with neonatal sepsis had significantly increased levels of E-alpha1-PI complex in comparison with those of vaginally delivered normal newborns. E-alpha1-PI complex levels were significantly decreased after lipid infusions of 0.5g/kg per day, but there was no further significant decrease with higher doses of the infusate. CONCLUSION: We observed the suppression neutrophil elastase levels by lipid infusions in newborn with sepsis. These results suggest that there were no appropriate chemotatic effects of neutrophil in newborn with sepsis. Therefore, we considered whether the lipid infusion was stopped if the newborn with sepsis was infused parenteral nutrition with intralipid.

High Dose of Amphotericin B in Intralipid Emulsion-based Delivery System in Immunocompromised Children with Invasive Fungal Infections

PURPOSE: Fungal infections are an important cause of morbidity and mortality in patients with hematologic malignancies. The therapy of choice in documented or suspected invasive fungal infections has been intravenous Amphotericin B (AmB). Adverse effects such as fever, chils, thrombophlebitis, nausea or vomiting are common. A more serious adverse effect is potential renal impairment. As AmB administration mixed with Intralipid (AmB/Intralipid) was reported to decrease AmB toxicity without a concomitant loss of antifungal efficacy, we studied the efficacy and side effects of long-term administration of AmB/Intralipid in leukemic children with invasive fungal diseases. METHODS: AmB/Intralipid was administered in seven leukemic children (male, 3; female, 4) who had invasive fungal infections between July 1994 and March 1997. RESULTS: AmB/Intralipid was administered at a mean concentration of 1.45mg/kg/day for a mean of 58.1 days with cumulative dose of 3.01g. Excluding 2 patients who succumbed to the underlying leukemia, 4 out of 5 remaining patients remained free of both fungal infection and leukemia. Chills associated with AmB/Intralipid were found 13 times in 4 patients. One patient could not continue the administration because of the chills on the 45th day of AmB/Intralipid. Renal and hepatic impairment greater than Grade II toxicity was found in each case, respectively. The other 6 patients showed mild elevation from the baseline, but remained within the normal limits. CONCLUSION: Long-term, high-dose AmB/Intralipid therapy can be safely and effectively used in immunocompromised children with invasive fungal infections.

Quantitative analysis and prediction of literatures on research and application of Intralipid / 肠外与肠内营养

Intralipid is a kind of important fat emulsion.It has been widely used clinically in severely ill patients,especially in the patients before and or after major operation since the 1980s.After retrieving the papers on Intralipid form MEDLINE CD ROM database from 1980 to 1994 and analysing them by linear regression analysis in literature metrology,We found a significant linear correlation between the yearly literature quantity and the dynamic time course (year).From 1980 to 1994,the average yearly growth rate of the literature was 1.16.According to the regression equation,it is predicted that the literature on Intralipid will increase at a rate of 2.07% per year.From this analysis,we think that the research of Intralipid is tending to stability and will be wonderful.

Studies on the Stability of Intralipid / 中国药房

The Parameters of stability of Intralipid, including sights of phase seperation, pH, ree fatty acids and particle size, were investigated after different periods of storage (up to 26 months) at temperatures of 8℃, 15℃, 30℃ and 40℃. The results indicate that during storage, phase seperation can occur but the emulsion system remains stable with no negative influence on its clinical use. It was found that the pH value decreased while the levels of free fatty acids increased after storage. Ppreserving at higher temperature can accelerate its hydrolysis.