EICOSANOIDS AND FAT EMULSIONS IN ACUTE RESPIRATORY-DISTRESS SYNDROME PATIENTS

Lipid emulsions have been associated with changes in pulmonary functio n. Although these changes were related to the physical effects of the infusion-induced lipemia on gas exchange, several animal and human stu dies suggest that the impairment in pulmonary function observed with l ipid infusions was mediated by prostaglandins. Prostaglandins are synt hesized enzymatically from essential fatty acids. We studied the effec ts of two lipid emulsions, with different amounts of essential fatty a cids (20% long-chain triacylglycerols [LCT] with 55% of linoleic acid and 7% of alpha linolenic acid in 100 g of emulsion, and a physical mi xture of 20% medium-chain triacylglycerols [MCT] and LCT with 26% of l inoleic acid and 4% of alpha linolenic acid in 100 g of emulsion), on plasma levels of eicosanoids in patients with acute respiratory distre ss syndrome (ARDS). Although in patients with ARDS, plasma levels of p rostanoids were higher than the reference values, neither lipid emulsi on, administered at the rate of 2 mg . kg(-1) . min(-1) induced signif icant changes in the eicosanoids except for a decrease in systemic-pul monary arterial 6-keto prostaglandin F-1 alpha difference. (C) Elsevie r Science Inc. 1997.