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Abstract
Hypertriglyceridemia has been noted in patients with acute pancreatitis and respiratory
failure. Utilizing an isolated, perfused, canine pulmonary lobe, the effect of triglyceride
infusion on pulmonary function was evaluated. When heparin was used to anticoagulate
the perfusion circuit, the addition of triglyceride to the autologous blood perfusate
resulted in massive weight gain (226 gm), intrapulmonary shunting (36%), and a marked
drop in pulmonary compliance (∼-50%). Heparin activates lipoprotein lipase, and therefore
some triglyceride in the perfusate was lipolyzed with a resultant increase in serum
free fatty acids (FFAs) to 253 μmole/dl. When anticoagulation of the perfusion circuit
was accomplished by defibrinogenation with Arvin, the addition of triglyceride to
the autologous blood perfusate caused minimal weight gain (28 gm), no intrapulmonary
shunting, and only a slight decrease in pulmonary compliance (22%). Arvin has no effect
on lipoprotein lipase, and the FFA level in the perfusate remained normal (< 70 μmole/dl).
Thus it appears that FFA release secondary to the action of pulmonary lipoprotein
lipase on blood triglyceride is the important pathogenic step in the induction of
respiratory failure in this model.
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References
- Respiratory and hemodynamic changes after injection of free fatty acids.J Surg Res. 1968; 8: 417
- Defibrinogenation with Arvin in thrombotic disorders.in: Scriabine A. ed 8. Platelets and thrombosis. University Park Press, Baltimore1974: 273
- The effects of ancrod, the coagulating enzyme from the venom of Malayan pit viper (A. rhodostoma) on prothrombin and fibrinogen metabolism and fibrinopeptide a release in man.J Lab Clin Med. 1978; 91: 592
- A pathogenesis for alcoholic pancreatitis.Surgery. 1975; 77: 754
- Acute pancreatitis with hyperlipemia.Surgery. 1971; 70: 53
- Acute pancreatitis with hyperlipemia: the incidence of lipid abnormalities in acute pancreatitis.Ann Surg. 1973; 177: 483
- Acute pancreatitis with hyperlipemia: evidence for a persistent defect in lipid metabolism.Am J Med. 1974; 56: 482
- Pancreatitis and hyperlipemia: a study of serum lipid alterations in 25 patients with acute pancreatitis.Medicine. 1966; 45: 161
- Respiratory insufficiency secondary to acute pancreatitis.Ann Surg. 1972; 175: 657
- Lipoprotein lipase inhibition in the hyperlipemia of acute alcoholic pancreatitis.N Engl J Med. 1963; 269: 943
- Respiratory failure in acute pancreatitis: a possible role for triglyceride.Ann Surg. 1979; 189: 509
- A new method for the determination of fibrinogen in small samples of plasma.J Lab Clin Med. 1951; 37: 316
- Acute pancreatitis with hyperlipemia: studies with an isolated perfused canine pancreas.Surgery. 1977; 82: 60
- The pathogenesis of pulmonary edema in acute pancreatitis.Ann Surg. 1975; 182: 505
- Principles of biochemistry.in: ed 8. McGraw-Hill Book Co, New York1973: 548
Article info
Publication history
Accepted:
October 14,
1979
Footnotes
☆Supported by National Institutes of Health grant No. 2-R01-AM19-646-03, and by research grant No. HL 01601 from the National Heart, Lung and Blood Institute (W.R.B.) of the National Institutes of Health, Bethesda, Md.
Identification
Copyright
© 1980 Published by Elsevier Inc.
