Ali J, Wood L D
J Surg Res. 1985 Jun;38(6):599-605. doi: 10.1016/0022-4804(85)90081-2.
To determine whether the oleic acid contained in intralipid injures the lung, we measured fractional lobar perfusion, lobar shunt, and edema (wet to dry weight ratios, W/D) in 20 open-chested mechanically ventilated dogs. Five dogs received oleic acid 0.03 g/kg injected into a lower lobe pulmonary artery. Ten received 0.5 cc/kg of 20% intralipid which contains the equivalent amount of oleic acid, five of these animals being heparinized. The same dose of oleic acid was also suspended in intralipid and administered to five heparinized dogs. Shunt and edema were measured in another five heparinized closed-chested dogs receiving 2 g/kg of intralipid IV over 1 hr. Half hour after intralipid or oleic acid, shunts did not change. At 2 1/2 hr, oleic acid alone increased lobar shunt from 4.6 +/- 1.4 to 40.8 +/- 24.9% while intralipid shunt remained unchanged with and without heparin. Lobar perfusion fell significantly with oleic acid from 29.3 +/- 2.3 to 17.8 +/- 5.6% while showing no change in the lobes not receiving oleic acid. When oleic acid was suspended in intralipid, shunt and perfusion changed less than with oleic acid alone. Mean W/D of the oleic acid lower lobe exceeded (P less than 0.05) W/D of the other lobes, including the lobe receiving oleic acid suspended in intralipid which had a W/D greater than the lobes receiving intralipid only. We conclude that intralipid has no acute deleterious effects on pulmonary gas exchange, blood flow distribution, or edema. Our data suggest that intralipid may protect the lung from the deleterious effects of fatty acids.
为了确定脂肪乳剂中所含的油酸是否会损伤肺脏，我们对20只开胸机械通气的犬进行了分叶肺灌注分数、肺叶分流和水肿（湿重与干重之比，W/D）的测量。5只犬经肺动脉下叶注入0.03 g/kg油酸。10只犬接受0.5 cc/kg含等量油酸的20%脂肪乳剂，其中5只动物进行肝素化处理。同样剂量的油酸也混悬于脂肪乳剂中并给予5只肝素化犬。另外5只肝素化闭胸犬在1小时内静脉输注2 g/kg脂肪乳剂，测量其分流和水肿情况。脂肪乳剂或油酸注入半小时后，分流无变化。在2.5小时时，单独使用油酸使肺叶分流从4.6±1.4%增加到40.8±24.9%，而无论有无肝素，脂肪乳剂组的分流均保持不变。油酸使肺叶灌注显著下降，从29.3±2.3%降至17.8±5.6%，而未接受油酸的肺叶无变化。当油酸混悬于脂肪乳剂中时，分流和灌注的变化小于单独使用油酸时。接受油酸的肺叶下叶平均W/D超过（P<0.05）其他肺叶，包括接受混悬于脂肪乳剂中的油酸的肺叶，其W/D大于仅接受脂肪乳剂的肺叶。我们得出结论，脂肪乳剂对肺气体交换、血流分布或水肿无急性有害影响。我们的数据表明，脂肪乳剂可能保护肺脏免受脂肪酸的有害影响。
