[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.145.232.99. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
November 1984

Amelioration of Metabolic Complications of Conventional Total Parenteral NutritionA Prospective Randomized Study

Author Affiliations

From the Department of Clinical Nutrition, Division of Surgery, City of Hope National Medical Center, Duarte, Calif.

Arch Surg. 1984;119(11):1294-1298. doi:10.1001/archsurg.1984.01390230060014
Abstract

• The most common metabolic complications of total parenteral nutrition (TPN), glucose intolerance and abnormal liver function, can be significantly reduced when 30% of the glucose calories are replaced by fat. We gave 88 patients either conventional TPN (CON-TPN, 25% dextrose and 4.25% amino acids) or modified TPN (MOD-TPN, 15% dextrose, fat, and 5% amino acids). The treatment groups were as follows: group A, no surgery with TPN only; group B, postoperative TPN; and group C, preoperative and postoperative TPN. Serial blood samples were analyzed for glucose, albumin, triglycerides, and insulin, and for liver function values. Nine patients manifested hyperglycemia and were removed from the study; seven patients had received CON-TPN and two had received MOD-TPN. In group A, the insulin level rose 50% less with MOD-TPN. There was a 50% smaller rise in the triglyceride, SGOT, and SGPT levels in patients who received MOD-TPN. Replacing one third of the TPN glucose calories with fat leads to better glucose tolerance and fewer hepatic complications.

(Arch Surg 1984;119:1294-1298)

×