Pulmonary arterial lipid deposit in newborn infants receiving intravenous lipid infusion.

Three newborn infants are described with a distinctive pulmonary arterial lipid lesion, characterized by a wide foamy layer of intima partially occluding the lumen of small muscular pulmonary arteries. Lipid stains indicated lipid infiltration of the walls of these arteries, involving not only the intimal layer, but media and adventitia as well. All three infants had received intravenous lipid infusions. All three infants also had histologic evidence of pulmonary hypertension, one on the basis of chronic lung disease (BPD) and two on the basis of congenital heart disease. A retrospective autopsy study of long-term neonatal ICU dwellers receiving such infusions revealed two additional patients with lipid deposits in pulmonary arterial walls. It is speculated that the pulmonary arterial lipid deposits were derived from the lipid infusions and were dependent on antecedent or concurrent vascular damage from pulmonary hypertension.