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Critical Care |

The Comparative Hemodynamic Effect of Lipid Emulsion That Was Infused Intravenously and Related Mechanism in an In Vivo Rat Heart Model

Ilwoo Shin*, MD; Il-Jeong Hwang, MD; Ju-Tae Sohn, MD; Young-Kyun Chung, MD; Heon-Keun Lee, MD
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Gyeongsang National University Hospital, Jinju, Republic of Korea


Chest. 2012;142(4_MeetingAbstracts):399A. doi:10.1378/chest.1376715
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Abstract

SESSION TYPE: Pharmacology in the ICU Posters

PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM

PURPOSE: Lipid emulsion has been used as a total parenteral nutrition component, resuscitation drug of local anesthetic induced cardiac toxicity, and therapeutic drug of non-local anesthetics drug toxicity. The aim of this study was to investigate the hemodynamic effect of lipid emulsions (a long-chain triglyceride (LCT) fat emulsion (Intralipid 20%), or a medium-chain triglyceride (MCT)/LCT emulsion (Lipofundin MCT 20%)) and its related mechanism that was infused intravenously in an in vivo rat heart model.

METHODS: Right femoral vein was cannulated for drug infusion. A micromanometer catheter was advanced into the left ventricle, via the right internal carotid artery, for measurement of hemodynamic function. First, the author measured the hemodynamic effect of Intralipid 20% that was intravenously infused. Hemodynamic measurements were recorded serially, along with the checking of the baseline and the maximum response after various dosage infusions. Second, the author checked for a dose-response curve of the L-NAME (nonselective NOS inhibitor) and obtained the dose of maximal contracture. Third, the author measured the hemodynamic effect of Intralipid 20% that was intravenously infused after L-NAME 10 mg/kg pretreatment. Fourth, the author measured comparative hemodynamic effect of the lipid emulsions (Intralipid 20%, Lipofundin MCT 20%).

RESULTS: Infusion of lipid emulsion resulted in a significant increase of the left ventricular systolic pressure and a tendency of increasing the left ventricular contractility. The increase of the left ventricular systolic pressure, which was induced by lipid emulsion, was abolished by the treatment of L-NAME. Lipofundin MCT 20% has more positive inotropic effect than that of Intralipid 20%.

CONCLUSIONS: Intravenously infused lipid emulsion caused the increase of left ventricular systolic pressure via mainly blockading of the nitric oxide release, at the vascular endothelial cell. Lipid emulsions have a different cardiovascular effect, depending on the triglyceride component.

CLINICAL IMPLICATIONS: Lipid emulsions can cause cardiovascular effect, depending on their component. Lipid emulsions should be used with caution in patients with compromised hemodynamic function.

DISCLOSURE: The following authors have nothing to disclose: Ilwoo Shin, Il-jeong Hwang, Ju-Tae Sohn, Young-Kyun Chung, Heon-Keun Lee

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Gyeongsang National University Hospital, Jinju, Republic of Korea

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