Intravenous lipids have been shown to have varying effects on coagulation parameters. A patient with short bowel syndrome and recurrent thrombotic episodes who required both intravenous lipids and anticoagulation is described. A constant infusion of a soybean oil emulsion (Intralipid) in his parenteral nutrient solution was demonstrated to interfere with the anticoagulant effect of warfarin. Termination of the infusion and rechallenge with warfarin resulted in prolongation of his prothrombin time to the therapeutic range. Reinstitution of a lipid-free parenteral nutrition regimen has allowed for successful continuation of warfarin therapy. (Journal of Parenteral and Enteral Nutrition11:316-318, 1987)
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References
1.
Simons BE, Jordan GL: Massive bowel resection. Am J Surg118:953-959, 1969
2.
Hamond HE: Massive resection of the small intestine. An analysis of 257 collected cases . Surg Gynecol Obstet61:693-705, 1935
Roth HC, Rosenthal W., Mandel EE: Lipemia-induced acceleration of intravascular clotting. Proc Soc Exp Biol Med101:516-519,1959
5.
Atik M.: Platelet dysfunction after intravenous infusion of fat emulsion. Acta Chir Scand466(Suppl):68-69, 1976
6.
Bergentz SE, Gelin LE, Rudenstam CM: Intravenous aggregation of blood cells following intravenous infusion of fat emulsions. Acta Chir Scand120:115-120, 1960
7.
Mandel EE, Mermall HL, Preston FW, et al: Effect of fat loading upon blood coagulation. Am J Clin Pathol30:11-18, 1958
8.
Artz CP, Conn JH, Bell WN: The effect of long term administration of intravenous fat on liver function and the coagulation mechanism. Surg Forum9:77-80, 1958
9.
Werr JA, Preston FW: Effect of intravenous fat emulsion on blood coagulation. Arch Surg79:213-219, 1959
10.
Meng HC, Kaley JS: Effects of multiple infusions of a fat emulsion on blood coagulation, liver function, and urinary excretion of steroids in schizophrenic patients . Am J Clin Nutr16:156-164, 1965
11.
Glueck HI, Viteri FE, Howard R., et al: The effect of intravenously administered fat on the coagulation mechanism. Am J Clin Nutr13:8-24, 1963
12.
Van Way CW, Dunn EL, Hamstra RD: The effect of intravenous safflower oil emulsion on the clotting mechanism. Ann Surg49:460-464, 1983
13.
Somani P., Leathem WD, Barlow AL: Safflower oil emulsion: Single and multiple infusions with or without added heparin in normal human volunteers. JPEN4:307-311, 1980
14.
Amris CJ, Brockner J., Larsen V.: Changes in the coagulability of blood during the infusion of Intralipid . Acta Chir Scand325 (Suppl):70-77, 1964
15.
Brockner J. , Amris CJ, Larsen V.: Fat infusions and blood coagulation. Effect of various fat emulsions on blood coagulation. Acta Chir Scand343 (Suppl):48-55, 1965
16.
Cronberg S. , Nilsson IM: Coagulation studies after administration of a fat emulsion, Intralipid. Thromb Diath Haemorrh18;664-669, 1967
17.
Rouser G., White SG, Schloredt D.: Phospholipid structure and thromboplastic activity. Biochim Biophys Acta28:71-80, 1958
18.
Wallach DFH , Maurice PA, Steele BB, et al: Studies on the relationship between the colloidal state and clot-promoting activity of pure phosphatidyl ethanolamines . J Biol Chem234:2829-2834, 1959
19.
Marcus AJ, Spaet TH: Platelet phosphatides: Their separation, identification, and clotting activity . J Clin Invest37:1836-1847, 1958
20.
Troup SB, Reed CF, Marinetti GV, et al: Thromboplastic factors in platelets and red blood cells: Observations on their chemical nature and function in in vitro coagulation. J Clin Invest39:342-351, 1960
21.
Daemen FJM , Van Arkel C., Hart HC, et al: Activity of synthetic phospholipids in blood coagulation. Thromb Diath Haemorrh13:194-217, 1965
22.
Papahadjopoulos D., Hougie C., Hanahan DJ: Influence of surface charge of phospholipids on their clot-promoting activity. Proc Soc Exp Biol Med111:412-416, 1962
