Radermacher P, Santak B, Strobach H, Schrör K, Tarnow J
Institut für Anaesthesiologie, Heinrich-Heine-Universität, Düsseldorf, FRG.
Intensive Care Med. 1992;18(4):231-4. doi: 10.1007/BF01709838.
Fat emulsions containing medium chain triglycerides (MCT) have recently been introduced into clinical practice as a component of total parenteral nutrition. Since several authors reported increased pulmonary artery pressure and impaired gas exchange during intravenous (i.v.) fat use, in particular in septic patients, we studied the pulmonary hemodynamic and gas exchange effects of i.v. fat containing MCT and long chain triglycerides (LCT) in patients with sepsis syndrome. As the effects of fat emulsions have been attributed to increased formation of prostanoids, the production of thromboxane A2 and prostacyclin was investigated by the determination of urinary thromboxane B2 and 6-keto-prostaglandin F2 alpha, respectively. The i.v. fat use did not induce any alterations in pulmonary hemodynamics and gas exchange, the distribution of ventilation and perfusion nor urinary prostaglandin content. We conclude that fat emulsions containing MCT induce little alterations in pulmonary hemodynamics and gas exchange. This result is probably due to reduced prostaglandin formation because fat emulsions containing MCT provide less prostaglandin precursors than pure LCT emulsions.
含中链甘油三酯（MCT）的脂肪乳剂最近已作为全胃肠外营养的一个组成部分引入临床实践。由于几位作者报告在静脉输注脂肪期间，尤其是在脓毒症患者中，肺动脉压升高且气体交换受损，我们研究了含MCT和长链甘油三酯（LCT）的静脉脂肪对脓毒症综合征患者肺血流动力学和气体交换的影响。由于脂肪乳剂的作用归因于前列腺素生成增加，分别通过测定尿血栓素B2和6-酮-前列腺素F2α来研究血栓素A2和前列环素的产生。静脉输注脂肪未引起肺血流动力学、气体交换、通气和灌注分布以及尿前列腺素含量的任何改变。我们得出结论，含MCT的脂肪乳剂在肺血流动力学和气体交换方面引起的改变很小。这一结果可能是由于前列腺素生成减少，因为含MCT的脂肪乳剂比纯LCT乳剂提供的前列腺素前体更少。
