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THROMBOXANES: THE LINK BETWEEN INTRALIPIDS AND PULMONARY VASOCONSTRICTION IN THE NEWBORN

During intralipid (IL) infusion, premature neonates demonstrate significant decreases in p0 which are accompanied by pulmonary vasoconstriction. The mechanism by which intralipids induce these changes is not yet known. This study was undertaken to evaluate the hypothesis that IL, via the provision of increased fatty acid precursors, acts by Increasing biosynthesis of the vasoconstricting prostanoid, thromboxane.Thirteen neonates (<1750 grams) who had not yet been fed, and were not expected to receive any enteral nutrition for 5 days were randomized to receive either TPN with IL (n=7) or TPN without IL (n=6). Plasma prostanoid levels were drawn on day 1, 3 and 5 of study and results are as follows:The data are consistent with the following conclusions: 1. IL provide increased essential fatty acid prostaglandin precursors; 2. These increased EFA precursors result in increased biosynthesis of the vasoconstricting prostanoid, thromboxane; and 3. Thromboxane thus produced may contribute to the observed pulmonary vasoconstriction.