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

Roy D. Goldfarb*, Thomas S. Parker, Daniel M. Levine, Dana Glock, Imran Akhter, Azzam Alkhudari, Robert J. McCarthy, Eric M. David, Bruce R. Gordon, Stuart D. Saal, Albert L. Rubin, Gordon M. Trenholme, Joseph E. Parrillo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

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)-α, 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.

Original languageEnglish (US)
Pages (from-to)R550-R557
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Volume284
Issue number2 53-2
DOIs
StatePublished - Feb 1 2003

Keywords

  • Cardiac contractility
  • Cardiac output
  • Lipoprotein
  • Serum endotoxin
  • Tumor necrosis factor

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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