Skeie B, Askanazi J, Rothkopf M M, Rosenbaum S H, Kvetan V, Thomashow B
Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY.
Crit Care Med. 1988 Feb;16(2):183-94. doi: 10.1097/00003246-198802000-00018.
Numerous studies have reported varying degrees of apparent pulmonary dysfunction when iv fat emulsions (IVFE) are given. These changes have generally not been of sufficient magnitude to carry clinical significance. The lung dysfunction observed has been attributed to an associated hyperlipemia. Recent studies, however, suggest that the associated impairment in lung function is due to alterations in pulmonary vascular tone (which results in ventilation/perfusion inequalities) caused by an IVFE-related increase in prostaglandin (PG) production. The polyunsaturated fatty acids in the IVFE serve as precursors to the PGs. Due to the varied effects of PGs on inflammation and pulmonary vasomotor tone, infusion of IVFE could have profound physiologic and pharmacologic actions aside from the provision of lipid calories. In some circumstances, IVFE may, in fact, be beneficial to the lung via alterations in
许多研究报告称,静脉输注脂肪乳剂(IVFE)时会出现不同程度的明显肺功能障碍。这些变化通常程度不足以具有临床意义。观察到的肺功能障碍归因于相关的高脂血症。然而,最近的研究表明,相关的肺功能损害是由于IVFE相关的前列腺素(PG)生成增加导致肺血管张力改变(从而导致通气/灌注不均)所致。IVFE中的多不饱和脂肪酸是PG的前体。由于PG对炎症和肺血管运动张力有多种影响,除了提供脂质热量外,输注IVFE还可能产生深远的生理和药理作用。在某些情况下,IVFE实际上可能通过改变……对肺有益。