Related Experiment Videos
Abnormal liver function in malnourished patients receiving total parenteral nutrition: a prospective randomized study
J A Tayek1, B Bistrian, N F Sheard
1Harbor-UCLA Medical Center, Torrance.
Journal of the American College of Nutrition
|February 1, 1990
Summary
Early intravenous lipid administration in total parenteral nutrition (TPN) did not prevent liver function abnormalities and was linked to increased aspartate aminotransferase. Duration of TPN, not lipid use, correlated with other liver enzyme elevations.
Area of Science:
- Clinical Nutrition
- Hepatology
- Parenteral Nutrition
Background:
- Liver function abnormalities are common in patients receiving total parenteral nutrition (TPN).
- The role of early intravenous lipid administration in mitigating these abnormalities is unclear.
Purpose of the Study:
- To investigate whether early intravenous lipid administration reduces liver function abnormalities in malnourished patients undergoing TPN.
- To assess the impact of lipid emulsion and TPN duration on liver enzymes.
Main Methods:
- Prospective study of 25 clinically malnourished patients over 4 weeks.
- Randomized assignment to TPN with or without early lipid infusion for the first week, followed by TPN with daily lipids for all.
- Regular monitoring of liver function tests, including AST, LDH, ALP, and GGT.
Main Results:
- Early lipid administration was associated with significant increases in AST and LDH levels.
- Alkaline phosphatase and GGT elevations were related to the overall duration of TPN, not early lipid use.
- The peak increase in AST occurred at day 7 in the early lipid group.
Conclusions:
- Early intravenous lipid administration in TPN may be associated with transient increases in certain liver enzymes like AST.
- The duration of TPN is a significant factor in the development of liver function abnormalities, particularly with ALP and GGT.
- Further research is needed to optimize lipid administration protocols during TPN.