// PACKAGE LEAFLET: INFORMATION FOR THE USER B. Braun Melsungen AG · Melsungen, Germany Lipofundin MCT/LCT 20 %. Infusion of Lipofundin® MCT/LCT 20% (1 ml/kg) resulted in a significant increase in left ventricular systolic pressure compared to that after infusing modified. Lipofundin® MCT/LCT 20% increase left ventricular systolic pressure in an ex vivo rat heart model via increase of intracellular calcium level.
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Lipid emulsions have been used to treat various drug toxicities and for total parenteral nutrition therapy. Their usefulness has also been confirmed in patients with local anesthetic-induced cardiac toxicity. The purpose of this study was to measure the hemodynamic and composition effects of lipid emulsions and to elucidate the mechanism associated with changes in intracellular calcium levels in myocardiocytes.
Lipofundin 20% induces hepatic lipid peroxidation in New Zealand white rabbits
We measured the effects of the lipid emulsions on intracellular calcium levels in H9c2 cells by confocal microscopy. Both lipid emulsion treatments increased intracellular calcium levels. These two lipid emulsions had different inotropic effects depending on their triglyceride component.
The inotropic effect of lipid emulsions could be related with intracellular calcium level. Lipid emulsions LE have been used as total parenteral nutrition TPN [ 12 ] and as therapeutic drugs for various drug toxicities, such as psychotropic drugs haloperidol and tricyclic antidepressants ljpofundin, calcium channel blockers, beta-blockers, parasiticides, or herbs lipofundim anesthetic drug toxicity [ 34 ].
Systemic local anesthetic toxicity is a rare but potentially fatal complication that is intractable to conventional cardiopulmonary resuscitation [ 5 ]. Systemic lipofujdin anesthetic toxicity also has a risk of progressing to “recurrent systemic local anesthetic toxicity after successful resuscitation” [ 6 ]. Intravenous infusion lipofjndin LEs reverses intractable cardiac toxicity in an animal model [ 78 ], and LEs are effective for treating local anesthetic-induced cardiac toxicity [ 3591011 ].
Therefore, various studies associated with LEs have been actively conducted to understand the mechanism of lipid rescue and improve treatment regimens.
However, both types of LE affect hemodynamics in an ex vivo model but the associated cellular mechanism remains unknown. Animal preparation and surgery were performed 02 described previously [ 12 ]. If the tail moved i. A tracheostomy was performed, and the animals were mechanically ventilated with room air via a 16 G catheter. The chest cavity was opened, and the heart was excised rapidly.
The heart was mounted quickly on a Langendorff perfusion system and perfused with modified Krebs-Henseleit solution mM NaCl, 4. Perfusion pressure was maintained at 70 mmHg lipfundin a 95 cm high fluid column and an overflow pump. Each experimental group was injected with the drug using an infusion pump Auto Syringe AS50 Infusion Pump; Baxter, Singapore through lipofundij three-way stopcock lioofundin the fluid column. The hanging hearts were assigned randomly to three groups as follows: The sample size calculation was based on a preliminary study.
Randomization was allocated by one author with a numbered container. Hemodynamic functions at baseline and the maximum response after the LE infusion were measured.
Cover slips were inserted into a chamber mounted on the stage of the confocal microscope and rinsed with a warm normal bath solution mM NaCl, 5. Fluorescent images were collected every 0. The LE concentration used was 0.
Veterinary World – March – – Abstract -1
All analyses were performed using SPSS statistical software ver. Experimental outcomes were analyzed using one-way analysis of variance and the Bonferroni post-hoc test. Hemodynamic functions were liopfundin at baseline and during the maximum response after LE infusion. LE-induced changes in intracellular calcium were detected by confocal microscopy.
Our results show that the LE treatments increased intracellular calcium level Fig.
The major findings of our study are: Although there are some reports indicate that long-chain triglycerides has have virtually no effect on hemodynamics [ 14 ], it lipofudnin a generally accepted that LE has a positive hemodynamic effect [ 1516 ].
However, a mixture of medium-chain triglycerides, long-chain triglycerides, and omega-3 polyunsaturated fatty acid emulsions increase mean aortic blood pressure [ 17 ]. We hypothesized that the hemodynamic effects of LEs may be dependent on their components. Therefore, careful observations of hemodynamic changes are needed during bolus infusion lipofundiin LEs. The second aim of this study was to elucidate the mechanism responsible for the LE-induced lipovundin in LVSP and intracellular calcium levels in myocardial cells.
Long chain fatty acids directly activate calcium channels at some lipid sites near the channels or on the channel protein itself, as assessed by the standard whole cell voltage clamp technique in ventricular myocytes [ 18 ]. Thus, we measured the change in calcium current after adding LEs to rat cardiac myoblastic H9c2 cells to lipoofundin their effect on calcium current.
Most of the lipofundln transduction pathways that stimulate inotropy ultimately involve calcium either by increasing calcium influx, by increasing release of calcium from the sarcoplasmic reticulum, or by sensitizing troponin-C to calcium [ 20 ]. LEs are used for various clinical purposes [ 12345 ] and have become an integral part of parenteral nutrition [ 12 ], effective treatment for local anesthetic-induced cardiovascular collapse [ 5 ], lippfundin treatment for lipophilic drug toxicity [ 34 ].
The mechanism of action of LEs for treating local anesthetic-induced cardiac toxicity is not completely understood. Moreover, it is unknown which LE is more effective for treating this condition.
However, local anesthetic-induced systemic toxicity is caused by inhibiting inotropic and metabotropic cell signal systems and possibly mitochondrial metabolism [ 8 ].
LIPOFUNDIN MCT/LCT 20% EMULSION FOR INFUSION
The “lipid sink theory” [ 48 ] reduced tissue binding by re-establishing equilibrium in the plasma lipid phase and the “energetic-metabolic effect” [ 421 ] reversal of lipofunfin mitochondrial fatty acid transport are the most widely known theories for the mechanism of action of LEs for treating local anesthetic-induced systemic toxicity.
In addition, a “positive inotropic effect” is proposed as another mechanism [ 9 ]. Our study had some limitations. First, the myoblastic H9c2 cell line was selected for this study.
We used these cells because they are derived from rat heart. However, these cells retain many skeletal muscle properties [ 22 ]. Thus, primary rat heart culture would have been more reasonable for this research.
However, it is technically challenging to obtain viable cultured myocytes. Second, we found that the LEs increase intracellular calcium levels. However, we did not verify the source of the increase or the channel involved. Thus, further research regarding the effect of calcium channel blockers on LE-induced increase in calcium is needed to elucidate the calcium source. In conclusion, LEs had positive inotropic effects in a perfused heart model.
The inotropic effect lipfoundin LEs may be related to lipofuncin intracellular calcium levels in the heart. Other authors declare that they have no conflict of interests to disclose concerning the contents of the paper. National Center for Biotechnology InformationU.
Journal List Korean J Anesthesiol v. Published online Jan Find articles by Jiyoung Park. Find articles by Yeon A Kim. Find articles by Jeong Yeol Han. Find lipofundln by Sangkyu Jin.
Find articles by Seong-Ho Ok. Find articles by Ju-Tae Sohn. Find articles by Heon-Keun Lee. Find articles by Young-Kyun Chung. Oipofundin articles by Il-Woo Shin. Author information Article notes Copyright and License information Disclaimer. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License http: This article has been cited lipofundn other articles in PMC. Abstract Background Lipid emulsions have been used to treat various drug toxicities and for total parenteral nutrition therapy.
Conclusions These two lipid emulsions had different inotropic effects depending on their triglyceride component. Calcium, Heart, Myocardial contraction, Intralipid, Lipofundin.
Introduction Lipid emulsions LE have been used as total parenteral nutrition TPN [ 12 ] and as therapeutic drugs for various drug toxicities, such as psychotropic drugs haloperidol and tricyclic antidepressantscalcium channel blockers, beta-blockers, parasiticides, or herbs non-local anesthetic drug toxicity [ 34 ]. Results Effect of LE on hemodynamic functions of hanging hearts in a Langendorff perfusion system Hemodynamic functions were checked at baseline and during the maximum response after LE infusion.
Open in a separate window. N indicates number of hearts. Effects of the lipid emulsions on intracellular calcium in H9c2 cells LE-induced changes in intracellular calcium were detected by li;ofundin microscopy. Effect of lipid emulsions 0. N indicates the number of independent experiments. Discussion The major findings of our study are: Intravenous fat emulsions in clinical practice. Intravenous lipid emulsion as antidote: Intravenous lipid emulsion in clinical toxicology.
Intractable cardiac arrest due to lidocaine toxicity successfully resuscitated with lipid emulsion. Recurrence of cardiotoxicity after lipid rescue from bupivacaine-induced cardiac arrest. Lipid emulsion improves recovery from lippfundin cardiac arrest, but not from ropivacaine- or mepivacaine-induced cardiac lipoundin.
Lipid rescue resuscitation from lipogundin anaesthetic cardiac toxicity. Ozcan MS, Weinberg G. Update on the use of lipid emulsions in local anesthetic systemic toxicity: Intravenous lipid infusion in the successful resuscitation of local anesthetic-induced cardiovascular collapse after supraclavicular brachial plexus block. Early use ljpofundin lipid emulsion to treat incipient mepivacaine intoxication. Reg Anesth Pain Med.
Effect of free fatty acids on myocardial function and oxygen consumption in intact dogs. Hemodynamic effects of lipids in humans.