Download PDF
Thromb Haemost 1996; 75(01): 083-086
DOI: 10.1055/s-0038-1650225
Original Article
Schattauer GmbH Stuttgart

Fat Emulsion Infusion Potentiates Coagulation Activation during Human Endotoxemia

Tom van der Poll
The Cornell University Medical College, Laboratory of Surgical Metabolism, New York, USA; Academic Medical Center, University of Amsterdam, Department of Internal Medicine and Center of Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Amsterdam, The Netherlands; Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Department of Autoimmune Diseases and Inflammation, Amsterdam, The Netherlands
,
Susette M Coyle
The Cornell University Medical College, Laboratory of Surgical Metabolism, New York, USA; Academic Medical Center, University of Amsterdam, Department of Internal Medicine and Center of Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Amsterdam, The Netherlands; Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Department of Autoimmune Diseases and Inflammation, Amsterdam, The Netherlands
,
Marcel Levi
The Cornell University Medical College, Laboratory of Surgical Metabolism, New York, USA; Academic Medical Center, University of Amsterdam, Department of Internal Medicine and Center of Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Amsterdam, The Netherlands; Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Department of Autoimmune Diseases and Inflammation, Amsterdam, The Netherlands
,
Marja A Boermeester
The Cornell University Medical College, Laboratory of Surgical Metabolism, New York, USA; Academic Medical Center, University of Amsterdam, Department of Internal Medicine and Center of Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Amsterdam, The Netherlands; Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Department of Autoimmune Diseases and Inflammation, Amsterdam, The Netherlands
,
Carla C Braxton
The Cornell University Medical College, Laboratory of Surgical Metabolism, New York, USA; Academic Medical Center, University of Amsterdam, Department of Internal Medicine and Center of Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Amsterdam, The Netherlands; Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Department of Autoimmune Diseases and Inflammation, Amsterdam, The Netherlands
,
Patty M Jansen
The Cornell University Medical College, Laboratory of Surgical Metabolism, New York, USA; Academic Medical Center, University of Amsterdam, Department of Internal Medicine and Center of Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Amsterdam, The Netherlands; Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Department of Autoimmune Diseases and Inflammation, Amsterdam, The Netherlands
,
C Erik Hack
The Cornell University Medical College, Laboratory of Surgical Metabolism, New York, USA; Academic Medical Center, University of Amsterdam, Department of Internal Medicine and Center of Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Amsterdam, The Netherlands; Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Department of Autoimmune Diseases and Inflammation, Amsterdam, The Netherlands
,
Stephen F Lowry
The Cornell University Medical College, Laboratory of Surgical Metabolism, New York, USA; Academic Medical Center, University of Amsterdam, Department of Internal Medicine and Center of Hemostasis, Thrombosis, Atherosclerosis and Inflammation Research, Amsterdam, The Netherlands; Central Laboratory of the Netherlands Red Cross Blood Transfusion Service, Department of Autoimmune Diseases and Inflammation, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 24 April 1995

Accepted after resubmission 10 October 1995

Publication Date:
27 July 2018 (online)

Also available at
  PDF Download  Permissions and Reprints

Summary

Intravenous fat emulsions are frequently given to malnourished patients who are prone to suffer from infectious complications. As injection of low dose endotoxin represents a model to study the human response to acute infection, we sought to determine the effect of lipid emulsion infusion on endotoxin-induced activation of the hemostatic mechanism in man. Ten healthy men received a bolus intravenous injection of endotoxin (lot EC-5; 20 U/kg) midway through a 4-h infusion (125 ml/h) of either dextrose 5% (n = 5) or Intralipid 20% (n = 5). Lipid infusion potentiated endotoxin-induced coagulation activation, as indicated by higher plasma levels of the prothrombin fragment FI + 2 and of thrombin-antithrombin III complexes (both p <0.05 for the difference between groups). However, lipid infusion did not influence the fibrinolytic response to intravenous endotoxin, as reflected by similar increases in the levels of tissue-type plasminogen activator and plas-min-α2-antiplasmin complexes in both groups. Endotoxin-induced appearance of plasminogen activator inhibitor type I was enhanced by lipid infusion (p <0.05). These data suggest that fat emulsion infusion may enhance the tendency towards thrombotic complications in patients with infections.

 

  • References

  • 1 Seidner DL, Mascioli EA, Istfan NW, Porter KA, Seileck K, Blackburn GL, Bistrian BR. Effects of long-chain triglyceride emulsions on reticuloendothelial system function in humans. J Parent Ent Nutr 1989; 13: 614-619
    CrossrefPubMedSearch in Google Scholar
  • 2 Robin AP, Arain I, Phuangsap A, Holian O, Roccaforte P, Barrett JA. Intravenous fat emulsion acutely suppresses neutrophil chemiluminescence. J Parent Ent Nutr 1989; 13: 608-613
    CrossrefPubMedSearch in Google Scholar
  • 3 Strunk RC, Kunke KS, Kolski GB, Revsin BK. Intralipid alters macrophage membrane fatty acid composition and inhibits complement (C2) synthesis. Lipids 1983; 18: 493-500
    CrossrefPubMedSearch in Google Scholar
  • 4 Gogos CA, Kalfarentzos FE, Zoumbos NC. Effect of different types of TPN on T lymphocyte subpopulations and NK cells. Am J Clin Nutr 1990; 51: 119-122
    CrossrefPubMedSearch in Google Scholar
  • 5 Freeman J, Goldmann DA, Smith NE, Siddebottom DG, Epstein MF, Platt R. Association of intravenous lipid emulsion and coagulase-negative staphylococcal bacteremia in neonatal intensive care units. N Engl J Med 1990; 323: 301-308
    CrossrefPubMedSearch in Google Scholar
  • 6 Levi M, ten Cate H, van der Poll T, van Deventer SJH. Pathogenesis of disseminated intravascular coagulation in sepsis. JAMA 1993; 270: 975-979
    CrossrefPubMedSearch in Google Scholar
  • 7 Montemurro P, Lattanzio A, Chetta G, Lupo L, Caputi-Iambrenghi L, Rubino M, Giordano D, Semeraro N. Increased in vitro and in vivo generation of procoagulant activity (tissue factor) by mononuclear phagocytes after Intralipid infusion in rabbits. Blood 1985; 65: 1391-1395
    PubMedSearch in Google Scholar
  • 8 Lattanzio A, Montemurro P, Pannarale O, Altomare DF, Palasciano N, de Rinaldis P, Semeraro N. Increased production of coagulant activity (tissue factor) by human peripheral blood monocytes after Intralipid infusion. Clin Nutr 1984; 3: 177-181
    CrossrefPubMedSearch in Google Scholar
  • 9 Wakefield A, Cohen Z, Craig M, Connolley P, Jeejeebhoy KN, Silverman R, Levy GA. Thrombogenicity of total parenteral nutrition solutions: I. Effect on induction of monocyte/macrophage procoagulant activity. Gastroenterology 1989; 97: 1210-1219
    CrossrefPubMedSearch in Google Scholar
  • 10 Wakefield A, Cohen Z, Rosenthal A, Craig M, Jeejeebhoy KN, Gotlieb A, Levy GA. Thrombogenicity of total parenteral nutrition solutions: II. Effect on induction of endothelial cell procoagulant activity. Gastroenterology 1989; 97: 1220-8
    CrossrefPubMedSearch in Google Scholar
  • 11 Altomare DF, Semeraro N, Colucci M. Reduction of the plasma levels of tissue plasminogen activator after infusion of a lipid emulsion in humans. J Parent Ent Nutr 1993; 17: 274-276
    CrossrefPubMedSearch in Google Scholar
  • 12 Van der Poll T, Lowry SF. Biological responses to endotoxin in humans. In: Modulation of the Inflammatory Response in Severe Sepsis Tellado JM, Forse RA, Solomkin JS. (eds) Basel; Karger AG: 1995. pp 18-32
  • 13 van Zonneveld AJ, Veerman H, Brakenhoff JPJ, Aarden LA, Cajot JF, Pannekoek H. Mapping of epitopes on human tissue-type plasminogen activator with recombinant deletion mutant proteins. Thromb Flaemost 1987; 57: 82-86
    PubMedSearch in Google Scholar
  • 14 De Boer JP, Abbink JJ, Brouwer MC, Meijer C, Roem D, Voom GP, Lambers JWJ, van Mourik JA, Hack CE. PAI-1 synthesis in the human hepatoma cell line Hep G2 is increased by cytokines. Evidence that the liver contributes to acute phase behaviour of PAI-1. Thromb Haemost 1991; 65: 181-185
    Thieme ConnectPubMedSearch in Google Scholar
  • 15 De Boer JP, Creasy AA, Chang A, Roem D, Brouwer MC, Eerenberg AJM, Hack CE, Taylor Jr FB. Activation patterns of coagulation and fibrinolysis in baboons following infusion with lethal or sublethal dose of Escherichia coli. Circ Shock 1993; 39: 59-67
    PubMedSearch in Google Scholar
  • 16 Levi M, ten Cate H, Bauer KA, van der Poll T, Edgington TS, Büller HR, van Deventer SJH, Hack CE, ten Cate JW, Rosenberg RD. Inhibition of endotoxin-induced activation of coagulation and fibrinolysis by pentoxifylline or by a monoclonal anti-tissue factor antibody in chimpanzees. J Clin Invest 1994; 93: 114-120
    CrossrefPubMedSearch in Google Scholar
  • 17 Buzby TP. Perioperative nutritional support. J Parent Ent Nutr 1990; 14 (suppl) 197-199
    CrossrefPubMedSearch in Google Scholar
  • 18 Maynard ND, Bihari DJ. Postoperative feeding. Time to rehabilitate the gut. BMJ 1991; 303: 1007-1008
    CrossrefPubMedSearch in Google Scholar
  • 19 van Deventer SJH, Büller HR, ten Cate JW, Aarden LA, Hack CE, Sturk A. Experimental endotoxemia in humans: analysis of cytokine release and coagulation, fibrinolytic and complement pathways. Blood 1990; 76: 2520-2526
    PubMedSearch in Google Scholar
  • 20 Biemond BJ, ten Cate H, Levi M, Soule HR, Morris LD, Foster DL, Bogo-witz CA, van der Poll T, Büller HR, ten Cate JW. Complete inhibition of endotoxin-induced coagulation activation in chimpanzees with a monoclonal Fab fragment against factor VII/VIIa. Thromb Haemost 1995; 73: 223-230
    Thieme ConnectPubMedSearch in Google Scholar
  • 21 Schlichting E, Henriksen T, Lyberg T. Lipoproteins do not modulate the tissue factor activity, plasminogen activator or tumour necrosis factor production induced by lipopolysaccharide stimulation of human monocytes. Scand J Clin Lab Invest 1994; 54: 465-473
    CrossrefPubMedSearch in Google Scholar
  • 22 Carvalho de SousaJ, Bruckert E, Giral P, Soria C, Chapman J, Truffert J, Dairou F, de Gennes JL, Caen JP. Coagulation factor VII and plasma triglycerides: decreased catabolism as a possible mechanism of factor VII hyperactivity. Haemostas 1989; 19: 125-130
    PubMedSearch in Google Scholar
  • 23 Carvalho de SousaJ, Soria C, Ayrault-Jarrier M, Pastier D, Bruckert E, Amiral J, Bereziat G, Caen JP. Association between coagulation factors VII and X with triglyceride-rich lipoproteins. J Clin Pathol 1988; 41: 940-944
    CrossrefPubMedSearch in Google Scholar
  • 24 Hallberg D, Wersall J. The electron-microscopic investigation of chylomicrons and fat emulsions for intravenous use. Acta Chir Scand Suppl 1964; 325: 23-25
    PubMedSearch in Google Scholar
  • 25 Hallberg D. Studies on the elimination of exogenous lipids from the blood stream. Acta Physiol Scand 1964; 62: 407-410
    CrossrefPubMedSearch in Google Scholar
  • 26 Boberg J, Carlson LA. Determination of heparin-induced lipoprotein lipase activity in human plasma. Clin Chim Acta 1964; 10: 420-427
    CrossrefPubMedSearch in Google Scholar
  • 27 Erkelens DW, Brunzell JD, Bierman EL. Availability of apolipoprotein CII in relation to the maximal removal capacity for an infused triglyceride emulsion in man. Metabolism 1979; 28: 495-501
    CrossrefPubMedSearch in Google Scholar
  • 28 Robinson D, Quardfordt S. Apoproteins in association with Intralipid incubations in rat and human plasma. Lipids 1979; 14: 343-349
    CrossrefPubMedSearch in Google Scholar
  • 29 Granot E, Deckelbaum RJ, Eisenberg S, Oschry Y, Bengtsson-Olivecrona G. Core modification of human low-density lipoprotein by artificial triacyl-glycerol emulsion. Biochim Biophys Acta 1985; 833: 308-315
    CrossrefPubMedSearch in Google Scholar
  • 30 Huth K, Schoenborn W, Knorpp K. Experimentelle Verbrauchskoagulopathie nach intravenöser Zufuhr von Fett und Endotoxin. Thrombos Diathes Haemorrh 1967; 17: 129-143
    PubMedSearch in Google Scholar
  • 31 Lo SK, Cheung A, Zheng Q, Silverstein RL. Induction of tissue factor on monocytes by adhesion to endothelial cells. J Immunol 1995; 154: 4768-4777
    PubMedSearch in Google Scholar
  • 32 Suffredini AF, Harpel PC, Parrillo JE. Promotion and subsequent inhibition of plasminogen activation after administration of intravenous endotoxin to normal subjects. N Engl J Med 1989; 320: 1165-1172
    CrossrefPubMedSearch in Google Scholar
  • 33 Haglund O, Wibell L, Saldeen T. Plasminogen activators and inhibitors of plasminogen activators in patients with deep venous thrombosis (DVT). Diurnal variation of the inhibitor. Thromb Haemost 1985; 54: 271-279
    PubMedSearch in Google Scholar
  • 34 Hamsten A, Wiman B, de Faire U, Blombäck M. Increased plasma levels of a rapid inhibitor of tissue plasminogen activator in young survivors of myocardial infarction. N Engl J Med 1985; 313: 1557-1563
    CrossrefPubMedSearch in Google Scholar
  • 35 Mehta J, Mehta P, Lawson D, Saldeen T. Plasma tissue plasminogen activator inhibitor levels in coronary artery disease: correlation with age and serum triglyceride concentrations. J Am Coll Cardiol 1987; 9: 263-268
    CrossrefPubMedSearch in Google Scholar
  • 36 Chakrabarti R, Hocking ED, Feamley GR, Mann RD, Attwell TN, Jackson D. Fibrinolytic activity and coronary artery disease. Lancet 1986; i: 987-990
    PubMedSearch in Google Scholar
  • 37 Falk E. Coronary thrombosis: pathogenesis and clinical manifestations. Am J Cardiol 1991; 68: 28B-35B
    CrossrefPubMedSearch in Google Scholar
  • 38 Report of a meeting of physicians and scientists, University College London Medical School. Hypertriglyceridaemia and vascular risk. Lancet 1993; 342: 781-787
    CrossrefPubMedSearch in Google Scholar
  • 39 Drake TA, Morrisey JH, Edgington TS. Selective cellular expression of tissue factor in human tissues. Implications for disorders of hemostasis and thrombosis. Am J Pathol 1989; 134: 1087-1097
    PubMedSearch in Google Scholar
  • 40 Brismar B, Härdstedt C, Malmborg AS. Bacteriology and phlebography in catheterization for parenteral nutrition. Acta Chir Scand 1980; 146: 115-119
    PubMedSearch in Google Scholar
  • 41 Brismar B, Härdstedt C, Jacobsen S. Diagnosis of thrombosis by catheter phlebography after prolonged central venous catheterization. Arch Surg 1981; 194: 779-784
    PubMedSearch in Google Scholar
  • 42 Burt ME, Dunnick NR, Drudy AG, Mather MM, Brennan MF. Prospective evaluation of subclavian vein thrombosis during total parenteral nutrition by contrast venography. Clin Res 1981; 20: 246A
    PubMedSearch in Google Scholar