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富含ω-3脂肪酸的脂质乳剂对急性呼吸窘迫综合征(ARDS)血流动力学和气体交换的影响:一项前瞻性、随机、双盲、平行组研究。

Effects on hemodynamics and gas exchange of omega-3 fatty acid-enriched lipid emulsion in acute respiratory distress syndrome (ARDS): a prospective, randomized, double-blind, parallel group study.

作者信息

Sabater Joan, Masclans Joan Ramon, Sacanell Judit, Chacon Pilar, Sabin Pilar, Planas Merce

机构信息

Intensive Medicine Department, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.

出版信息

Lipids Health Dis. 2008 Oct 23;7:39. doi: 10.1186/1476-511X-7-39.

Abstract

INTRODUCTION

We investigated the effects on hemodynamics and gas exchange of a lipid emulsion enriched with omega-3 fatty acids in patients with ARDS.

METHODS

The design was a prospective, randomized, double-blind, parallel group study in our Intensive Medicine Department of Vall d'Hebron University Hospital (Barcelona-Spain). We studied 16 consecutive patients with ARDS and intolerance to enteral nutrition (14 men and 2 women; mean age: 58 +/- 13 years; APACHE II score: 17.8 +/- 2.3; Lung Injury Score: 3.1 +/- 0.5; baseline PaO2/FiO2 ratio: 149 +/- 40). Patients were randomized into 2 groups: Group A (n = 8) received the study emulsion Lipoplus 20%, B.Braun Medical (50% MCT, 40% LCT, 10% omega-3); Group B (n = 8) received the control emulsion Intralipid Fresenius Kabi (100% LCT). Lipid emulsions were administered during 12 h at a dose of 0.12 g/kg/h. Measurements of the main hemodynamic and gas exchange parameters were made at baseline (immediately before administration of the lipid emulsions), every hour during the lipid infusion, at the end of administration, and six hours after the end of administration lipid infusion.

RESULTS

No statistically significant changes were observed in the different hemodynamic values analyzed. Likewise, the gas exchange parameters did not show statistically significant differences during the study. No adverse effect attributable to the lipid emulsions was seen in the patients analyzed.

CONCLUSION

The lipid emulsion enriched with omega-3 fatty acids was safe and well tolerated in short-term administration to patients with ARDS. It did not cause any significant changes in hemodynamic and gas exchange parameters.

TRIAL REGISTRATION

ISRCTN63673813.

摘要

引言

我们研究了富含ω-3脂肪酸的脂质乳剂对急性呼吸窘迫综合征(ARDS)患者血流动力学和气体交换的影响。

方法

本研究为前瞻性、随机、双盲、平行组研究,在巴塞罗那西班牙瓦尔德希伯伦大学医院重症医学科进行。我们连续研究了16例ARDS且不耐受肠内营养的患者(14例男性和2例女性;平均年龄:58±13岁;急性生理与慢性健康状况评分系统II(APACHE II)评分:17.8±2.3;肺损伤评分:3.1±0.5;基线动脉血氧分压/吸入氧分数值(PaO2/FiO2)比值:149±40)。患者被随机分为两组:A组(n = 8)接受研究用乳剂Lipoplus 20%,贝朗医疗(50%中链甘油三酯(MCT),40%长链甘油三酯(LCT),10%ω-3);B组(n = 8)接受对照乳剂费森尤斯卡比英脱利匹特(100% LCT)。脂质乳剂以0.12 g/kg/h的剂量输注12小时。在基线(脂质乳剂给药前即刻)、脂质输注期间每小时、给药结束时以及脂质输注结束后6小时测量主要血流动力学和气体交换参数。

结果

在所分析的不同血流动力学值中未观察到统计学上的显著变化。同样,在研究期间气体交换参数也未显示出统计学上的显著差异。在所分析的患者中未发现归因于脂质乳剂的不良反应。

结论

富含ω-3脂肪酸的脂质乳剂在短期给予ARDS患者时是安全且耐受性良好的。它未引起血流动力学和气体交换参数的任何显著变化。

试验注册

ISRCTN63673813

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