F67INTRAVASCULAR FAT ACCUMULATION AFTER INTRALIPID INFUSION TO THE VERY LOW BIRTH WEIGHT INFANT. J.Hertel, I.Tygstrup, G.E.Andersen. The Neonatal Dept GN 5024 and Dept. of Ped.Pathology, Rigshospital, Copenhagen, Denmark.

Lipid accumulation in the lungs and brains was studied at autopsy in 21 newborn infants with a birthweight below 1500 grams, who dies in our de- partment within the last 30 months. Mean birth weight was 1050 grams (ran- ge 540-1440). Mean gestational age was 29 weeks (range 28-34). Nine in- fants received 20% IntralipidR (Vitrum, Stockholm) as continous intrave- nous infusion in a mean amount of 2.0 5 0.5 grams/kg/day of fat (+IL). Twelve infants haft been fed human milk and intravenous carbohydrates only, but no Intralipid (-IL). The two groups were similar with respect to birth weight, gestational age and Apgar scores. The survival time, how- ever, was longer in the +IL group. Lungs and brains were fixed in 10% for- mol-saline and after cryostate sections, stained with oil-red-O. Diagnosis of lipid accumulation was made without knowledge of + or - IL. Intravas- cular lipid accumulation in the lungs was a frequent finding in +IL, but was even found in two -IL infants (Table) and was not correlated with birth weight or gestational age. Since no lipid was found in the brain capillaries we do not believe that intralipid particles are retained in the lung capillaries by simple filtration.

+IL : IBrain CapiOllaries 1 Capil ;ries 1 ML::!:z:$s 1 Alveyar cells

-IL 12 0 / I 2 7 i 6

I

F68 UTILISATION OF LIPID EMULSIONS PARENTERPfLY ADMINISTERED TO PRE- MATURE INFANTS. FIRST STUDIES WITH THE C - TRIOLEIN BREATH TEST

H. Paust, D. Rating, W. Park, H. Helge. Children’s Hospital, Freie UniversitHt Berlin, FRG

No data have been found to date for premature infants and newbornsIFonce,rning the oxydation of enterally and parenterally administered lipids. The C-triolein breath test presents a method that will giveI3vidence on the extent and the ratppf the fatty acid oxydation. This method usef3 C-triolein marked with e stable C at the CI position of the fatty acid, the being administered enterally and parenterally without side effects. The

C#iolein

CO2 resulting from the fatty acid oxydation is breathed out via the lungs and,& spontaneous breathing, collected in a bag by means of a mask and a valve. The CO

& concentration is determined by

ass spectrometer (Finnigan MAT 1) and the result is defined as elimination per time unit, giving particulars about the fatty acid

oxydation during the examination period. First studies on 15 premature infants @JiO-1700 g birth weight) have shown that after intravenous adminstration of 1Omg

C-trioiem 24 to 30 per cent of the administered dose are oxydated within four hours. The present individual results give rise to the assumption that the oxydation rate might depend upon the maturity of the premature infants.

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