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Effect of parenteral fat emulsion on the pulmonary and reticuloendothelial systems in the newborn infant
Insights
This study examined lipid changes in low-birth-weight infants receiving Intralipid during total parenteral nutrition. Prolonged Intralipid infusion may alter pulmonary and reticuloendothelial system function due to accumulated lipids.
Area of Science:
- Neonatal nutrition
- Lipid metabolism
- Parenteral nutrition
Background:
- Low-birth-weight infants often require total parenteral nutrition (TPN).
- Intralipid, a lipid emulsion, is a common component of TPN.
- Assessing the metabolic and physiological effects of Intralipid in neonates is crucial.
Observation:
- Analysis of plasma and red blood cells (RBCs) in two infants receiving Intralipid for 9-12 weeks.
- Elevated plasma triglycerides (TG) and free fatty acids (FFA) were observed, not visible by plasma inspection.
- Increased linoleic acid and decreased arachidonic acid in plasma phospholipids (PL) were noted.
Findings:
- Infants receiving Intralipid showed higher plasma TG and FFA levels compared to controls.
- Accumulation of lipid globules was observed in lung tissue (alveolar macrophages and capillaries).
- Alterations in fatty acid composition of plasma PL were detected.
Implications:
- Prolonged Intralipid administration may lead to lipid accumulation in pulmonary and reticuloendothelial systems.
- Potential for altered pulmonary and reticuloendothelial system function in infants on long-term Intralipid.
- Further research is warranted to understand the long-term consequences of Intralipid therapy in neonates.
Abstract:
Analysis of phospholipids (PL), cholesterol esters, triglycerides (TG), and free fatty acids (FFA) was performed on plasma and RBCs in two sick low-birth-weight infants who received total parenteral nutrition including Intralipid for the first 9 and 12 weeks of life, respectively. There was an increase in the total concentration of the plasma IG and FFA in the infants receiving Intralipid as compared with controls. These elevated lipid levels were not detected by visual inspection of the plasma. When compared with control infants, higher levels of linoleic acid were found in the plasma and RBCs of infants receiving Intralipid while plasma PL contained less arachidonate. Histological examination of the lung in both infants who received Intralipid revealed numerous globules of sudanophilic material in alveolar macrophages and capillaries. There is a possibility that prolonged administration of Intralipid may be associated with altered pulmonary and reticuloendothelial system function.