Protein-free phospholipid emulsion treatment improved cardiopulmonary function and survival in porcine sepsis

American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Roy D GoldfarbJoseph E Parrillo

Abstract

Lipoprotein phospholipid (PL) plays a major role in neutralization of endotoxin. This study tested the hypothesis that prophylactic administration of a PL-enriched emulsion (PRE), which augments PL content of serum lipoproteins and neutralizes endotoxin in vitro, would preserve cardiovascular function and improve survival in porcine septic peritonitis. A control group was compared with low-, mid-, and high-dose treatment groups that received PRE by primed continuous infusion for 48 h. A fibrin clot containing live Escherichia coli 0111.B4 was implanted intraperitoneally 30 min after the priming dose. Survival increased in a dose-dependent manner and was correlated with serum PL. Infused PL was associated with high-density lipoprotein in the low-dose group and all serum lipoproteins at higher doses. Treatment significantly lowered serum endotoxin and tumor necrosis factor (TNF)-alpha, preserved cardiac output and ejection fraction, and attenuated increases in systemic and pulmonary vascular resistances. This study demonstrated that augmentation of lipoprotein PL via administration of PRE improved survival and offered a novel therapeutic approach to sepsis.

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Citations

Nov 10, 2006·Intensive Care Medicine·Oliver MurchChristoph Thiemermann
Dec 18, 2013·Journal of Medical Engineering & Technology·Ismail CinelR Phillip Dellinger
Jan 18, 2011·The Journal of Surgical Research·Roy D GoldfarbR Phillip Dellinger
Nov 7, 2009·Critical Care Clinics·Sergio L Zanotti-Cavazzoni, Roy D Goldfarb
Jul 8, 2009·The Veterinary Clinics of North America. Equine Practice·Gal Kelmer
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Feb 1, 2005·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·Eduardo EsteveJosé Manuel Fernández-Real
Jul 28, 2016·Journal of Veterinary Pharmacology and Therapeutics·A H Werners
Jan 7, 2004·Critical Care Medicine·R Phillip Dellinger, Joseph E Parrillo
Feb 17, 2009·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Pavel VyroubalZdenek Zadak
Dec 24, 2005·Shock·Roy D GoldfarbJoseph E Parrillo
Sep 23, 2009·Critical Care Medicine·R Phillip DellingerLipid Infusion and Patient Outcomes in Sepsis (LIPOS) Investigators
May 26, 2011·Expert Review of Anti-infective Therapy·Mark Tidswell, Steven P LaRosa
Apr 30, 2008·Current Opinion in Anaesthesiology·Raquel Nahra, R Phillip Dellinger
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Related Concepts

Cardiac Output
Dose-Response Relationship, Drug
Emulsions
Endotoxins
Escherichia Coli Infections
Alpha-1 Lipoprotein
Secondary Peritonitis
Phospholipids
Respiratory Tract Structure
Tumor Necrosis Factor-alpha

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