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[The effect of 2 lipid emulsions on platelet function]
1Servicio de Medicina Intensiva, Hospital General Universitario Valle de Hebrón, Barcelona, España.
Nutricion Hospitalaria
|July 1, 1993
Summary
Two lipid emulsions used in total parenteral nutrition did not alter platelet aggregation or activation in critical patients. Platelet function parameters remained stable, indicating no significant changes with either Intralipid or Lipofundina administration.
Area of Science:
- Nutrition and Metabolism
- Hematology
- Critical Care Medicine
Background:
- Total parenteral nutrition (TPN) is essential for critically ill patients.
- Lipid emulsions are a key component of TPN, but their effects on platelet function are not fully understood.
- Nonseptic critical patients often exhibit altered inflammatory and hemostatic profiles.
Purpose of the Study:
- To investigate the impact of two different lipid emulsions on platelet aggregation, activation, and eicosanoid production in nonseptic critical patients receiving TPN.
- To compare the effects of Intralipid (long-chain triglycerides) and Lipofundina (medium- and long-chain triglycerides) on platelet function.
Main Methods:
- A randomized study design was employed with two groups of nonseptic critical patients receiving TPN.
- Patients received either Intralipid or Lipofundina, providing 43% of non-protein calorific needs.
- Platelet function parameters, including aggregability, beta-thromboglobulin (beta TG), platelet factor 4 (PF4), thromboxane B2, and 6-keto-prostaglandin F1 alpha, were assessed before and after 4 and 7 days of TPN.
Main Results:
- Platelet aggregability did not significantly differ from normal throughout the study.
- Platelet activation markers (beta TG and PF4) were significantly elevated from baseline but did not change with either lipid emulsion.
- Thromboxane B2 levels remained high with considerable individual variability, while 6-keto-prostaglandin F1 alpha showed a non-significant trend towards decrease.
Conclusions:
- Administration of Intralipid or Lipofundina in TPN did not induce significant changes in platelet aggregation or activation in nonseptic critical patients.
- Despite baseline alterations in platelet activation and eicosanoid production, the studied lipid emulsions did not exacerbate these changes.
- Further research may be needed to elucidate the complex interplay between TPN lipid formulations and hemostasis in critical illness.