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Abstract

Septic shock induces physiologic and hemodynamic responses that may alter the host's ability to metabolize an exogenous source of lipids. The present study examined the metabolic changes occuring during septic shock in the young animal receiving an intravenous fat emulsion. Five 8-wk-old male Beagle puppies were studied. Each animal served as his own control twice, during which time ¹⁴C-palmitic acid alone or with a 10% fat emulsion (Liposyn) was administered. Septic shock (cardiac output less than 50% of control) was induced with an intravenous bolus of live Escherichia coli. During shock the puppies received intravenous ¹⁴C-palmitic acid and Liposyn. The mean respiratory quotient for the shock dogs (0.96 ± 0.01) was significantly (p < 0.05) higher than that of the controls (0.83 ± 0.06). The amount of expired ¹⁴CO₂ was 25.0 ± 15.9% for the shock animals, 53.9 ± 28.1% for the Liposyn controls, and 75.7 ± 30.5% for the controls receiving only ¹⁴C-palmitic acid (these differences are all significant, p < 0.05). After the onset of shock, serum triglyceride levels peaked within 2 min at 851 ± 540 mg/100 ml and remained elevated at 333 ± 213 mg/100 ml. Triglyceride levels in the Liposyn control animals returned to baseline values (54 ± 13 mg/100 ml) at the end of the 4-hr experimental period. Free fatty acids in the shock dogs reached a maximal level of 1.44 ± 0.09 mEq/liter at 1 hr and remained at this elevated value for a significantly longer period of time than in the Liposyn control puppies. Glycerol value followed a similar pattern and cholesterol remain unchanged. Plasma insulin in the shock animals steadily rose to a peak of 826 ± 358 μU/ml at the end of the experimental period; control animals showed no plasma insulin changes. The results of this study suggest that exogenous lipids administered during septic shock may not be metabolized as well as during the nonshock state. (Journal of Parenteral and Enteral Nutrition 8:652-656. 1984)

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References

Horwitz DL : Effects of endotoxin and E. coli shock on the metabolism of lipids and carbohydrate . Adv Exp Biol Med 23:195-202, 1971

Lanza-Jacoby S. Lansey SC Cleary MP et al: Alterations in lipogenic enzymes and lipoprotein lipase activity during gram-negative sepsis in the rat. Arch Surg 117:144-147, 1982

Fiser RH Denniston JC , Beisel WR : Endotoxemia in the Rhesus monkey: Alterations in host lipid and carbohydrate metabolism. Pediatr Res 8 :13-17, 1974

Cook JA , Wise WC , Callihan CS : Resistance of essential fatty acid-deficient rats to endotoxic shock . Circ Shock 6:333-342, 1979

Gallin JI , Kaye D. , O'Leary WM : Serum lipids in infection. N Engl J Med 281:1081-1086, 1969

Griffiths J. , Groves AC , Leung FYT : The relationship of plasma catecholamines to serum triglycerides in canine gram-negative bacteremia. Surg Gynecol Obstet 134:795-798, 1972

Fiser RH , Denniston JC , Beisel WR : Infection with Diplococcus pneumoniae and Salmonella typhimurium in monkeys: changes in plasma lipids and lipoproteins. J Infect Dis 125:54-60, 1972

Hirsch RL , McKay DG , Travers RI , et al: Hyperlipidemia, fatty liver, and bromosulfophthalein retention in rabbits injected intravenously with bacterial endotoxins. J Lipid Res 5:563-568, 1964

Kaufmann RL , Matson CF , Rowberg AH , et al: Defective lipid disposal mechanisms during bacterial infection in Rhesus monkeys. Metabolism 25:615-624, 1976

10.

Wannemacher RW Jr , Kaminski MV , Dinterman RE , et al: Use of lipid calories during pneumococcal sepsis in the Rhesus monkey. JPEN 6:100-105, 1982

11.

Nordenstrom J. , Carpentier YA , Askanazi J. , et al: Metabolic utilization of intravenous fat emulsion during total parenteral nutrition. Ann Surg 196:221-231, 1982

12.

Long JM III , Wilmore DW , Mason AD Jr , et al: Effect of carbohydrate and fats intake on nitrogen excretion during total intravenous feeding. Ann Surg 185:417-422, 1977

13.

Jeffay H. , Alvarez J. : Liquid scintillation counting of C-14. Anal Chem 33:612-615, 1961

14.

Brobeck JR : Energy exchange. IN Medical Physiology, Mountcastle VB (eds). The C.V. Mosby Company, St. Louis, MO, 1980, pp 1239-1245

15.

Martin MJ , Horwitz DL , Nattrass M. , et al: Effects of mild hyperinsulinemia on the metabolic response to exercise. Metabolism 30:668-694, 1981

16.

Benner JW , Polley TZ , Strodel WE , et al: Fluid resuscitation in live Escherichia coli septic shock in puppies. J Pediatr Surg 15:527-530, 1980

17.

Connors RH , Coran AG , Drongowski RA , et al: Corticosteroid therapy in hemorrhagic and septic shock in puppies . J Pediatr Surg 15:790-796, 1980

18.

Connors RH , Coran AG , Drongowski RA , et al: Combined fluid and corticosteroid therapy in septic shock in puppies. World J Surg 7:661-668, 1983

19.

Hinshaw LB , Archer LT , Beller-Todd BK , et al: Survival of primates in LD100 septic shock following steroid/antibiotic therapy. J Surg Res 28:151-170, 1980

20.

Munro AN : Metabolic integration of organs in health and disease. JPEN 6:271-279, 1982

21.

Beisel WR : Impact of infectious disease upon fat metabolism and immune functions . Cancer Res 41:3797-3798, 1981

22.

Allen DJ , Hillman CC , Ashmore J. : Studies on a biphasic lipolytic response to catecholamines in isolated fat cells. Biochem Pharmacol 18:2233-2240, 1969

The Metabolism of an Exogenous Lipid Source during Septic Shock in the Puppy

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