par Haumont, Dominique ;Deckelbaum, Richard J.;Richelle, Myriam ;Dahlan, Winai ;Coussaert, Eddy;Bihain, Bernard;Carpentier, Yvon
Référence The Journal of pediatrics, 115, 5 PART 1, page (787-793)
Publication Publié, 1989
Référence The Journal of pediatrics, 115, 5 PART 1, page (787-793)
Publication Publié, 1989
Article révisé par les pairs
Résumé : | Because 10% and 20% intravenously administered lipid emulsions (Intralipid preparations) differ in their phospholipid/triglyceride ratio (0.12 and 0.06, respectively), 28 low birth weight infants requiring parenteral nutrition for at least 1 week were selected at random to receive either emulsion to determine the effects on plasma lipids and lipoproteins. Triglyceride intake was progressively increased to reach 2 gm/kg per day between days 4 and 7. During that period, all plasma lipids in samples taken 6 hours after infusion were higher in the 10% intrallpid group. In comparison with day 0 values, triglyceride concentrations decreased (63±7 to 45±4 mg/dl; p<0.05) in the 20% group. Cholesterol levels increased in both groups, but the rise was more than twofold higher in the 10% group. Phospholipid increase was approximately 25% in the 20% group but more than 125% in patients receiving the 10% emulsion (p<0.005). The changes in plasma cholesterol and phospholipid levels were almost entirely in low-density lipoproteins. After 7 days, eight infants from each group were given the alternate emulsion, which resulted in a reversal of lipid patterns in each patient. We conclude that the higher phospholipid intake in 10% than in 20% intralipid is associated with higher plasma triglyceride concentrations and leads to accumulation of cholesterol and phospholipids in low-density lipoproteins. Emulsions with lower phospholipid content may be preferable for low birth weight infants and perhaps other patient populations with impaired removal of parenteral fat emulsions. © 1989 The C. V. Mosby Company. |