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January 1979, Vol 114, No. 1 >
ARTICLE | January 1979

Postmortem Findings in Three Patients Treated With Intravenous Fat Emulsions FREE

Ib Hessov, MD; Flemming Melsen, MD; Agner Haug, MD
[+] Author Affiliations

Accepted for publication May 3, 1978.

Reprint requests to Surgical Department of Gastroenterology L, Århus Kommunehospital, DK-8000 Århus C, Denmark (Dr Hessov).


Arch Surg. 1979;114(1):66-68. doi:10.1001/archsurg.1979.01370250068014
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• Three patients died of intercurrent illness in relation to intravenous nutrition with fat emulsions (20% Intralipid). In two cases, postmortem findings showed milky white, shiny, clotted lumps in the heart, with a fatty acid composition resembling that of fat emulsions. In vitro investigations make it likely that fibrin deposits in hyperlipemic plasma composed the lumps. In two cases, 30- to 50-μ Sudan-positive accumulations were found in the small vessels of the lungs, the cerebrum, and the kidneys.

(Arch Surg 114:66-68, 1979)

REFERENCES

1 +
Hallberg D, Holm I, Obel AL, et al:  Fat emulsions for complete intravenous nutrition . Postgrad Med J 43:307-316, 1967;.
2 +
Lee HA: Parenteral Nutrition in Acute Metabolic Illness . New York, Academic Press Inc, 1974;, pp 419-420.
3 +
Obel AL:  Morphological studies in long-term experiments with intravenous fat emulsions in dogs , in Berg G (ed): Advances in Parenteral Nutrition . Stuttgart, Germany, Georg Thieme-Verlag, 1970;, pp 206-216.
4 +
Freund U, Krausz Y, Levis IS, et al:  Iatrogenic lipidosis following prolonged intravenous hyperalimentation . Am J Clin Nutr 28:1156-1160, 1975;.
5 +
Gigon JP, Enderlin F, Scheidegger S:  Uber das Schicksal infudierter Fettemulsionen in der menschlichen Lunge . Schweiz Med Wochenschr 96:71-75, 1966;.
6 +
Wilmore DW, Moylan JA, Helmkamp GA, et al:  Clinical evaluation of a 10% intravenous fat emulsion for parenteral nutrition in thermally injured patients . Ann Surg 178:503-511, 1973;.
7 +
Födisch HJ, Propst A, Mikuz G:  Fettüberladungs-syndrom nach parenteraler Zufuhr von Lipidemulsionen . Verh Dtsch Ges Pathol 56:431-435, 1972;.
8 +
Depisch D:  Bedroliche Hyperlipämie im Rahmen eines allergischen Schocks bei parenteraler Ernährung einer Tetanuspatienten . Anaethesist 20:437-441, 1971;.
9 +
Belin RP, Bivin BA, Jona JZ, et al:  Fat overload with a 10% soybean oil emulsion . Arch Surg 111:1391-1393, 1976;.
10 +
Zohrab WJ, McHattie JD, Jeejeebhoy KN:  Total parenteral alimentation with lipid . Gastroenterology 64:583-592, 1973;.
11 +
Kapp JP, Duckert F, Hartmann G:  Platelet adhesiveness and serum lipids during and after Intralipid infusions . Nutr Metab 13:92-99, 1971;.
12 +
Hallberg D:  Elimination of exogenous lipids from the bloodstream . Acta Physiol Scand [ (Suppl 254) ] 65:1-22, 1965;.
13 +
Lawson LJ:  Parenteral nutrition in surgery . Br J Surg 52:795-800, 1965;.
14 +
Milewski B, Scostak WB, Medrzejewski et al:  Studies on the intravenous fat tolerance test in patients with compensated liver cirrhosis and chronic aggressive hepatitis . Pol Arch Med Wewn 50:259-262, 1973;.
15 +
Kaufmann RL, Matson CF, Rowberg AH, et al:  Defective lipid disposal mechanisms during bacterial infection in rhesus monkeys . Metabolism 25:615-624, 1976;.

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1 +
Hallberg D, Holm I, Obel AL, et al:  Fat emulsions for complete intravenous nutrition . Postgrad Med J 43:307-316, 1967;.
2 +
Lee HA: Parenteral Nutrition in Acute Metabolic Illness . New York, Academic Press Inc, 1974;, pp 419-420.
3 +
Obel AL:  Morphological studies in long-term experiments with intravenous fat emulsions in dogs , in Berg G (ed): Advances in Parenteral Nutrition . Stuttgart, Germany, Georg Thieme-Verlag, 1970;, pp 206-216.
4 +
Freund U, Krausz Y, Levis IS, et al:  Iatrogenic lipidosis following prolonged intravenous hyperalimentation . Am J Clin Nutr 28:1156-1160, 1975;.
5 +
Gigon JP, Enderlin F, Scheidegger S:  Uber das Schicksal infudierter Fettemulsionen in der menschlichen Lunge . Schweiz Med Wochenschr 96:71-75, 1966;.
6 +
Wilmore DW, Moylan JA, Helmkamp GA, et al:  Clinical evaluation of a 10% intravenous fat emulsion for parenteral nutrition in thermally injured patients . Ann Surg 178:503-511, 1973;.
7 +
Födisch HJ, Propst A, Mikuz G:  Fettüberladungs-syndrom nach parenteraler Zufuhr von Lipidemulsionen . Verh Dtsch Ges Pathol 56:431-435, 1972;.
8 +
Depisch D:  Bedroliche Hyperlipämie im Rahmen eines allergischen Schocks bei parenteraler Ernährung einer Tetanuspatienten . Anaethesist 20:437-441, 1971;.
9 +
Belin RP, Bivin BA, Jona JZ, et al:  Fat overload with a 10% soybean oil emulsion . Arch Surg 111:1391-1393, 1976;.
10 +
Zohrab WJ, McHattie JD, Jeejeebhoy KN:  Total parenteral alimentation with lipid . Gastroenterology 64:583-592, 1973;.
11 +
Kapp JP, Duckert F, Hartmann G:  Platelet adhesiveness and serum lipids during and after Intralipid infusions . Nutr Metab 13:92-99, 1971;.
12 +
Hallberg D:  Elimination of exogenous lipids from the bloodstream . Acta Physiol Scand [ (Suppl 254) ] 65:1-22, 1965;.
13 +
Lawson LJ:  Parenteral nutrition in surgery . Br J Surg 52:795-800, 1965;.
14 +
Milewski B, Scostak WB, Medrzejewski et al:  Studies on the intravenous fat tolerance test in patients with compensated liver cirrhosis and chronic aggressive hepatitis . Pol Arch Med Wewn 50:259-262, 1973;.
15 +
Kaufmann RL, Matson CF, Rowberg AH, et al:  Defective lipid disposal mechanisms during bacterial infection in rhesus monkeys . Metabolism 25:615-624, 1976;.

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