Puntis J W, Wilkins K M, Ball P A, Rushton D I, Booth I W
Institute of Child Health, University of Birmingham, Birmingham Maternity Hospital.
Arch Dis Child. 1992 Dec;67(12):1475-7. doi: 10.1136/adc.67.12.1475.
After prolonged parenteral nutrition a 12 month old infant died with pulmonary hypertension and granulomatous pulmonary arteritis. A review of necropsy findings in 41 infants who had been fed parenterally showed that two of these also had pulmonary artery granulomata, while none of 32 control patients who died from sudden infant death syndrome had similar findings. Particulate contaminants have been implicated in the pathogenesis of such lesions and these were quantified in amino acid/dextrose solutions and fat emulsions using automated particle counting and optical microscope counting respectively. Parenteral feed infusions compounded for a 3000 g infant according to standard nutritional regimens were found to include approximately 37,000 particles between 2 and 100 microns in size in one day's feed, of which 80% were derived from the fat emulsion. In-line end filtration of intravenous infusions may reduce the risk of particle associated complications. A suitable particle filter is required for use with lipid.
一名12个月大的婴儿在接受长期肠外营养后死于肺动脉高压和肉芽肿性肺动脉炎。对41名接受肠外喂养的婴儿尸检结果的回顾显示，其中两名婴儿也有肺动脉肉芽肿，而32名死于婴儿猝死综合征的对照患者均无类似发现。颗粒污染物被认为与此类病变的发病机制有关，分别使用自动颗粒计数和光学显微镜计数对氨基酸/葡萄糖溶液和脂肪乳剂中的颗粒污染物进行了量化。按照标准营养方案为一名3000克婴儿配制的肠外营养液，在一天的喂养中发现含有约37000个大小在2至100微米之间的颗粒，其中80%来自脂肪乳剂。静脉输液的在线终端过滤可能会降低与颗粒相关并发症的风险。使用脂质时需要合适的颗粒过滤器。
