Pulmonary vascular effects of fat emulsion infusion in unanesthetized sheep. Prevention by indomethacin.
Pulmonary vascular effects of fat emulsion infusion in unanesthetized sheep. Prevention by indomethacin.
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脂肪乳剂输注对未麻醉绵羊肺血管的影响。
DOI：
10.1172/jci109046
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发表时间：
1978
期刊：
影响因子：
--
通讯作者：
T. Harris
中科院分区：
文献类型：
--
作者：
C. R. McKeen;K. Brigham;R. Bowers;T. Harris
当输注10%脂肪乳时，人体的肺弥散能力和动脉血Po(2)降低。为了研究其对肺循环和肺液平衡的影响，我们将 0.25 g/kg x h 的 10% 脂肪乳剂（Intralipid，Cutter Laboratories, Inc.，Berkeley，CA）注入清醒的羊肺淋巴制剂中。该乳剂导致肺动脉压力持续增加至基线的大约两倍，而左心房压力几乎没有变化。 Pa(O2) 平均降低 13 托，肺淋巴流量增加两到三倍。淋巴/血浆总蛋白浓度随淋巴流量增加而下降；淋巴/血浆蛋白减少的幅度与之前报道的肺血管压力机械升高时的情况相似。肝素输注（负荷剂量 = 4,000 U，维持剂量 = 2,000 U/h）可清除血清中的甘油三酯，但不会改变对脂肪乳的反应。吲哚美辛输注（负荷剂量 = 5 mg/kg，维持剂量 = 3 mg/kg x h）可阻止肺动脉压升高、肺淋巴流量增加和 Pa(O2) 下降。脂肪乳输注不会改变血管外肺水和[(14)C]尿素肺血管通透性表面积乘积。我们得出的结论是，绵羊输注脂肪乳通过增加血管压力来增加肺微血管滤过，但对血管通透性没有影响。由于该作用被吲哚美辛阻断，因此它们可能是前列腺素介导的。
Pulmonary diffusing capacity and arterial blood Po(2) decrease in humans when 10% fat emulsion is infused. To study its effects on the pulmonary circulation and lung fluid balance, we infused 0.25 g/kg x h of a 10% fat emulsion (Intralipid, Cutter Laboratories, Inc., Berkeley, Calif.) into an awake sheep lung lymph preparation. The emulsion caused a sustained increase in pulmonary artery pressure to approximately twice base line with little change in left atrial pressure. Pa(O2) decreased an average 13 torr and lung lymph flow increased two- to threefold. Lymph/plasma total protein concentration fell as lymph flow increased; the magnitude of the lymph/plasma protein decrease was similar to that reported previously when lung vascular pressures were mechanically elevated. Heparin infusion (loading dose = 4,000 U, maintenance dose = 2,000 U/h) cleared the serum of triglycerides but did not alter the response to fat emulsion. Indomethacin infusion (loading dose = 5 mg/kg, maintenance dose = 3 mg/kg x h) blocked the rise in pulmonary artery pressure, the increase in lung lymph flow, and the fall in Pa(O2). Neither extravascular lung water nor [(14)C]urea lung vascular permeability surface area products were altered by fat emulsion infusion. We conclude that fat emulsion infusion in sheep increases lung microvascular filtration by increasing vascular pressures, but has no effect on vascular permeability. Since the effects are blocked by indomethacin, they may be prostaglandin mediated.