Objective: To examine the effect of two lipid emulsions administered with total parenteral nutrition (TPN) on platelet aggregation and activation and the production of eicosanoids in nonseptic critically ill patients.
Design: Prospective, randomized, unblinded, non-crossover study.
Setting: ICU of a general teaching hospital.
Patients: 23 adult, critically ill, nonseptic patients, who were in need of TPN for at least 7 days.
Interventions: The patients were randomly distributed into 2 groups each of which received TPN with a different essential fatty acid content. The 2 lipid emulsions, Intralipid 20% (long-chain triglycerides) and Lipofundin MCT/LCT 20% (10% each of long- and medium-chain triglycerides) provided 43% of the nonprotein caloric requirements calculated for each patient. Parameters demonstrating platelet function (plasma beta-thromboglobulin, platelet factor 4, platelet aggregation, 6-keto-PGF1 alpha) were assessed before starting TPN and after 4 and 7 days of initiation.
Results: Before beginning lipid perfusion, platelet activation evaluated by beta TG and PF4 levels was notable, 6-keto-PGF1 alpha production was elevated and no hyperaggregation of platelets was observed in patients. The studies of platelet function at 4 and 7 days of TPN did not show significant changes with respect to the basal data or between the 2 groups.
Conclusions: Our results indicate that platelet function was not affected by either of the 2 lipid emulsions administered to patients during the study period.