Intralipid and preterm

Pregnant rhesus monkeys were studied to determine the precise time in relation to photoperiod of the onset, and the nature, of the switch in myometrial activity patterns from contractures to contractions. We investigated both spontaneous term labor and androstenedione-induced preterm labor. Under general anesthesia at 127 +/- 2 days gestation (dGA) (mean +/- SEM), 16 pregnant rhesus monkeys were instrumented with maternal femoral arterial and venous catheters and myometrial electromyogram electrodes. Eight animals (group I) received continuous i...

AIMS: To study the frequency and nature of histiocytes in the splenic red pulp of infants who died following complicated immaturity/prematurity. METHODS: Twenty four preterm/immature infants were investigated. Frozen sections of formalin fixed splenic tissue were stained with Oil Red O. Paraffin wax sections from the same tissue were conventionally stained with haematoxylin and eosin. Immunohistochemistry was carried out for a number of macrophage markers. The administration of Intralipid was compared with the presence and extent of tissue macrophages...

The effect of 10% or 20% Intralipid on lipid clearing enzymes, plasma lipids and apoproteins was investigated during the first 5 days after birth in 37 premature infants maintained on total parenteral nutrition; 21 infants received 20% and 16 received 10% Intralipid, respectively. Lipid was infused over a 20-h period at rates of 1, 2 and 3 g/kg/day on consecutive days. Plasma lecithin: cholesterol acyltransferase (LCAT) activity was low and increased significantly (p<0.05) only during infusions of 3 g/kg/day in both groups of infants...

OBJECTIVE: Our purpose was to investigate the temporal relationship between delta4-androstenedione-induced preterm switching of myometrial activity patterns from contractures to contractions and maternal plasma estradiol and oxytocin concentrations in the 0.8 gestation rhesus monkey. STUDY DESIGN: Eight rhesus monkeys (132 to 136 days' gestation) were instrumented under halothane with femoral artery and vein catheters and uterine electromyogram electrodes. At 138 to 142 days' gestation baseline maternal femoral artery blood samples for estradiol and oxytocin measurement were taken at 30-minute intervals for 7 hours, starting 2 hours before the onset of darkness...

To determine the incidence of essential fatty acid (EFA) deficiency during short term fat-free parenteral nutrition, the authors investigated prospectively the EFA status of nine low birthweight (1145 +/- 343 g) preterm (28.2 +/- 1.9 weeks) infants, in whom delivery of dietary fat was delayed postnatally for 2-9 days. Serial determinations of plasma fatty acids showed that during fat-free alimentation, the major EFA, linoleic acid (LA), decreased rapidly (-0.75% total fatty acids per day), accompanied by a rise in endogenously produced non-essential fatty acid, eicosatrienoic acid (Mead acid)...

The unsaturated fatty acids that make up a large component of the lipid emulsion Intralipid are highly susceptible to peroxidation, and the products of this reaction could explain the toxicity that has been associated with the administration of some emulsions. Lipid peroxidation produces hydroperoxides, which can alter arachidonic acid metabolism or react to form organic free radicals, which then stimulate a cascade of damage to endogenous lipids. The lipid hydroperoxides and their breakdown products are also mutagens and carcinogens...

Pulmonary fat embolism in a preterm infant receiving Intralipid intravenously is described. Serum obtained at the time of clinical deterioration agglutinated Intralipid. This coincided with the onset of septicaemia and with a raised serum C reactive protein concentration. Subsequent clinical improvement was associated with reduction in the C reactive protein concentration and nonagglutination of Intralipid.

Eighteen low birth weight infants (27-34 wk gestation) were given supplementary parenteral nutrition via peripheral veins of a maximal dose of 8.5 g glucose, 2.5 g amino acids (Aminovenös päd 10%) and 2 g soybean oil egg lecithin emulsion (Intralipid 10%) kg body weight/24 hr. The fat emulsion was infused continuously at a rate of 0.084 g/kg body weight/hr. The elimination of Intralipid from the blood stream was controlled by enzymatic determination of serum triglyceride concentrations, and the fatty acid pattern of the serum lipids was determined by gas chromatography...

Eight preterm infants who died after 'Intralipid' infusion had fat accumulation in the lungs. The rate of infusion in six of the infants was below the recommended maximum for preterm infants and in no case was the plasma lipaemic on regular visual inspection. Histological examination revealed varying degrees of lung involvement. The commonest finding was distension of empty pulmonary capillaries, but specific staining techniques for fat showed that the capillaries were engorged with large lipid globules. Removal of accumulated fat by histiocytes was seen in infants dying some time after cessation of intralipid infusion...

The tolerance for intravenously administered Intralipid in 262 premature and sick newborns was studied. The serum concentrations of triglycerides and of free fatty acids were determined during total parenteral nutrition including Intralipid in a maximum daily dose of 2 g/kg. A serum concentration of 1.5 mmol/l or higher was found in 270 out of 985 triglyceride determinations (27.4%). In the 262 infants serum triglyceride concentrations were found elevated once or more in 117 cases (44.7%). Serum free fatty acids concentrations were normal...

The effects of Intralipid (IL) administration of preterm infants have been investigated. For this purpose, adult neutrophils were stimulated by infant sera collected before and after IL treatment. A definite decrease (p less than 0.0005) in chemoattractant capacity of zymosan-activated serum was observed after IL. On the other hand, no difference in the opsinizing abilities of untreated versus treated sera could be demonstrated by measuring the chemiluminescence responses to serum-opsonized zymosan. This study emphasized the need of caution in the use of IL treatment for preterm infants...

The level of naturally occurring tocopherols in blood serum of 88 preterm infants, aged from birth to 2 years, was determined by the high performance liquid chromatographic (HPLC) method using fluorescence detection. In 11 cases, patients were assayed for their tocopherol status in longitudinal studies, receiving known amounts of vitamin E supplements orally and/or parenterally. No correlation was found between serum alpha-tocopherol level and gestational age nor birth weight. All preterm infants receiving the vitamin E preparation showed an average serum tocopherol content of more than 0...

Organotypic cell culture systems of human fetal lungs of 15, 18, and 26 weeks' gestational age were treated with Intralipid, a phosphatidylcholine-containing lipid mixture, and with hydrocortisone of varying concentrations. The lamellar bodies found in the pneumocytes type II were ultrastructurally identified. Their amount was quantitated by point-counting, a morphometrical method. Intralipid had a stimulating effect upon the surfactant production depending on the concentration admitted. This effect was quantitatively compared to the known effect of hydrocortisone...

During a 24-hour interval, examination was carried out of 5 full-term and 4 preterm newborns in whom no disturbance of postnatal adaptation was found. The newborns received parenteral nutrition using infusates containing 20% Intralipid during 7 hours on the average. The mean daily dose of Intralipid was 1.2 g/kg, infusion rate was 0.17 g/kg/h. The concentration of FFA (n = 9) and ABC/Bi was examined three times in the course of 24 hours, and that prior to Intralipid administration, after one-hour infusion, and approximately 17 hours after the end of infusion...

Plasma cholesterol and lecithin concentrations are regulated by the serum enzyme lecithin: cholesterol acyltransferase (LCAT). LCAT activity is low in cord blood of premature infants, suggesting that in these infants the hypercholesterolemia associated with Intralipid infusion might be due to low LCAT activity. The serum LCAT activity has not been quantitated in preterm infants receiving intravenous fat emulsions. We have therefore quantitated LCAT activity in eleven premature infants maintained on total parenteral nutrition (TPN)...

Lipid emulsions used in parenteral nutrition are prone to peroxidation that may be an important feature of oxygen-associated tissue damage. Incubation of lipid emulsion [Intralipid (IL)] with H2O2 and FeCl2 increased lipid peroxidation, measurable as increased production of pentane, from 0.39 +/- 0.33 to 0.99 +/- 0.18 microM (p less than 0.0001). Malondialdehyde was increased from 0.010 +/- 0.005 mM to 0.380 +/- 0.025 mM (p less than 0.001). Superoxide dismutase and catalase (each 100 U/mL) or vitamin C (10 mM) inhibited pentane and malondialdehyde production (p less than 0...

Hypercholesterolemia is common in preterm infants administered 10% Intralipid perhaps because of excess phospholipid in plasma causing efflux of cholesterol from tissues. The purpose of this study was to determine if cholesterol synthesis (as measured by plasma lathosterol) is increased in preterm infants (23-32 wk gestation) during infusion of up to 4 g 10% Intralipid/kg body wt/d. Two groups of infants were studied. Intralipid intake was compared to: 1) plasma cholesterol in blood sampled over the first 100 d of life (preliminary study, n = 22) and 2) plasma cholesterol, lathosterol, and apo AI and B in blood taken at birth (cord), d 3-4 of life, and at least three additional times over the next 25 d (lathosterol study, n = 22)...

10% Intralipid was infused (1 g/kg body wt.) intravenously for 15 min with Razel pumps to each of eight selected newborn preterm infants whose general condition and pulmonary status were stable for at least 24 h before study. Six of the eight infants showed greater than 10 mmHg reduction in oxygen tension of umbilical arterial blood. These reductions were correlated with elevated triglyceride concentrations. The findings suggest that Intralipid-induced lipaemia has the potential to lower the oxygen tension of the blood and hence patients with pre-existing pulmonary insufficiency may be at risk from hypoxaemia...