• J R Masclans, R Iglesia, B Bermejo, M Picó, R Rodriguez-Roisin, and M Planas.
• Serveis de Medicina Intensiva, Medicina Preventiva, and Hematologia, Hospital General Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
• Intensive Care Med. 1998 Sep 1; 24 (9): 918923918-23.

ObjectiveTo investigate the gas exchange and pulmonary haemodynamic responses to two different intravenous fat emulsions in patients with acute respiratory distress syndrome (ARDS).DesignProspective, randomized, double-blind, placebo-controlled study.SettingIntensive care unit in a university-affiliated hospital.Patients21 patients with ARDS [mean age, 57 +/- 3 (SEM) years; Acute Physiology and Chronic Health Evaluation II, 20 +/- 3; Murray's score, 2.85 +/- 0.12] consecutively admitted.InterventionsPatients were assigned to three groups (n = 7 each): group A (LCT) received long-chain triglycerides (20% LCT), group B (MCT/LCT), medium-chain triglycerides/long-chain triglycerides (20% MCT/LCT: 50/50) and group C placebo (0.9% sodium chloride, NaCl). The infusion was always given at the rate of 2 mg/kg min over a total period of 12 h, with a volume infusion of 500 ml in each group.MeasurementsData were collected before, immediately after and 12 h after infusion ceased. Pulmonary and systemic haemodynamic and gas exchange variables were measured at each time point. Serum triglyceride cholesterol, and non-esterified fatty acids levels were measured.ResultsDuring LCT infusion, cardiac output, oxygen consumption and oxygen delivery increased (all p < 0.05), whereas pulmonary haemodynamics, arterial oxygen tension, mixed venous partial pressure of oxygen and venous admixture ratio remained essentially unaltered. No changes were observed following MCT/LCT infusion.ConclusionsThe administration of LCT emulsion given at a slow rate did not alter arterial oxygenation because of the beneficial effect of a high cardiac output, hence offsetting the detrimental effect of increased O2 consumption.

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