Abstract
We have previously documented decreased oxygenation during infusion of 1 g/kg Intralipid (IL) over 4 h (0.25 g/kg/h) in premature infants with respiratory illnesses (Pediatr. 66:26,1980). To examine the effect of slow infusion rates and lipid dosage on oxygenation, 16 AGA premature infants with RDS (BW mean ± SEM - 1.26 kg ± 0.04; EGA 29.9 wks ± 0.34; Postnatal age 4.0 days ± 0.26 - p = NS vs. previous study group) maintained on total parenteral nutrition were given 1, 2 and 3 IL g/kg/day over 15 h (IL g/kg/h = 0.067, 0.133, 0.20) on day 1, 2 and 3 respectively. Arterial blood gases (for calculation of alveolar-arterial oxygen gradients-AaDO2) and blood for free fatty acid (FFA) and triglyceride (TG) analysis were drawn before and at the end of IL infusion.There was a significant effect of IL infusion rate on ΔAaDO2 (p<.001 by ANOVA). A significant correlation was noted betweenΔ AaDO2 and end-infusion FFA concentration (r=.36, p<.01). No correlation between AaDO2 and TG concentration was seen. These data demonstrate that slower infusion rates decrease the adverse effect of lipids on oxygenation in premature infants recovering from RDS. (NIH Grants HD-15631 & RR-00240)
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