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The effect of infusion of fat emulsion on pulmonary function was determined in 18 patients with major burns and smoke inhalation injury. Lung compliance was monitored, as was arterial oxygenation, the latter by using the ratio of PaO2/FiO2. Mean burn size was 41% of total body surface area (TBSA). Preinfusion lung function was PaO2/FiO2=260 (normal >450). Chest x-rays were also monitored. Lipid emulsion was infused beginning on postburn day 3 for an eight-hour period each day. Average infusion was 900 cc of a 10% solution approximating 40% of calculated nonprotein calories. There was no change in lung function during or after infusion compared to the baseline value. Pulmonary edema was not evident on chest x-rays. Lipid was rapidly cleared from plasma, as evidenced by postinfusion triglyceride levels exceeding 300 mg/dl in only two patients. It seems that fat emulsion does not alter lung function in burn patients with an inhalation injury.