Pscheidl E M, Wan J M, Blackburn G L, Bistrian B R, Istfan N W
Nutrition-Metabolism Laboratory, New England Deaconess Hospital, Harvard Medical School, Boston, MA 02215.
Metabolism. 1992 Jul;41(7):698-705. doi: 10.1016/0026-0495(92)90307-v.
Alteration in regional blood flow is important in the pathogenesis of organ failure during endotoxemia and sepsis. In particular, intestinal ischemia is thought to enhance the translocation of bacteria into the systemic circulation. We used radioactive microspheres to measure the influence of two intravenous (IV) dietary fats (vegetable oil containing high levels of omega-6 fatty acids, and fish oil containing high levels of omega-3 fatty acids) on regional blood flow during low-dose Escherichia coli endotoxin infusion (0.1 mg/100 g body weight [BW]) in a rat model. Despite absence of changes in the cardiac output, blood flow rates to the small and large intestines, stomach, and pancreas, and also to the skin and skeletal muscle were significantly reduced after 18 hours of endotoxin infusion in the rats fed standard vegetable oil. Short-term IV feeding during a period of 40 hours with an isonitrogenous, isocaloric nutrient solution containing fish oil as the only lipid source normalized intestinal perfusion and increased blood flow to the liver and spleen. Low-dose endotoxin infusion also resulted in significant increases in glucose, lactate, and pyruvate concentrations. In comparison to standard vegetable fat emulsion, fish oil significantly reduced these parameters. A second experiment was conducted to measure lactate kinetics. Based on the dilution of U-14C-lactate, fish oil feeding was associated with higher lactate clearance than standard vegetable oil feeding during the endotoxin infusion. We conclude that short-term IV feeding with fish oil improves intestinal perfusion and portal blood flow, improves glucose tolerance, and increases lactate clearance in a low-dose endotoxin rat model.
局部血流改变在内毒素血症和脓毒症所致器官衰竭的发病机制中具有重要作用。特别是,肠道缺血被认为会增强细菌向体循环的移位。我们使用放射性微球来测量两种静脉内(IV)膳食脂肪(富含ω-6脂肪酸的植物油和富含ω-3脂肪酸的鱼油)对低剂量大肠杆菌内毒素输注(0.1mg/100g体重[BW])大鼠模型中局部血流的影响。尽管心输出量没有变化,但在喂食标准植物油的大鼠中,内毒素输注18小时后,小肠、大肠、胃和胰腺以及皮肤和骨骼肌的血流速率显著降低。在40小时内,用含鱼油作为唯一脂质来源的等氮、等热量营养液进行短期静脉喂养,可使肠道灌注正常化,并增加肝脏和脾脏的血流。低剂量内毒素输注还导致葡萄糖、乳酸和丙酮酸浓度显著升高。与标准植物脂肪乳剂相比,鱼油显著降低了这些参数。进行了第二项实验来测量乳酸动力学。基于U-14C-乳酸的稀释,在内毒素输注期间,喂食鱼油比喂食标准植物油具有更高的乳酸清除率。我们得出结论,在低剂量内毒素大鼠模型中,短期静脉输注鱼油可改善肠道灌注和门静脉血流,改善葡萄糖耐量,并增加乳酸清除率。