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Journal of Parenteral and Enteral Nutrition
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Influence of Lipid Infusion (0.4 g/kg/hr) and Positive End Expiratory Pressure (8 cm H2O) on Pulmonary Function and Hemodynamics in Healthy Anesthetized Pigs

Hellfried Rosegger, M.D.

University Children's Hospital

Gerhard Trittenwein, M.D.

Institute of Anaesthesiology, and the University Hospital for Surgery

Hellfried Metzler, M.D.

Institute of Anaesthesiology, and the University Hospital for Surgery

Karl-Heinz Tscheliessnig, M.D.

Department of Experimental Surgery, University of Graz, Graz, Austria

Wolfgang Hermann, M.D.

Department of Experimental Surgery, University of Graz, Graz, Austria

Fat emulsions are used increasingly for parenteral nutrition in premature infants suffering from various disorders, including respiratory insufficiency necessitating artificial ventilation with positive end expiratory pressure (PEEP). Both PEEP and lipid infusions (LI) may alter pulmonary hemodynamics. The simultaneous effect of LI and PEEP were therefore investigated. Five adult anesthetized Göttinger mini-pigs were infused with a 20% LI at a high rate of 0.4 g/kg/hr for 30 min, followed by PEEP of 8 cm H2O for 15 min. Catheters were inserted into the upper vena cava, the pulmonary artery, the right and left atrium, and the aorta, and pressures recorded continuously. Ventilation volume, respiratory fractional gas concentrations of O2 and CO2 (mass snectrometer). and blood gases were measured. The following parameters were calculated : total peripheral resistance, pulmonary arteriolar resistance, right-to-left shunt (Qs/QT ) dead space ventilation (VD/ VT) and effective compliance.

Total peripheral resistance remained unchanged. Pulmonary arteriolar resistance increased significantly during PEEP, PEEP + LI, but not during LI alone. QS/QT increased significantly during LI and returned to normal when PEEP was applied. VD/VT and effective compliance did not change during LI. The increased right to left shunt, caused by LI, is reduced by means of PEEP, while the pulmonary arteriolar resistance increased with PEEP and LI.

Journal of Parenteral and Enteral Nutrition, Vol. 5, No. 5, 410-413 (1981)
DOI: 10.1177/0148607181005005410
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[Abstract] [PDF]