Abnormal liver function during parenteral nutrition: Relation to infusion excess

Abstract

Abnormalities of liver function are frequently noted during the course of total parenteral nutrition (TPN) [6, 9, 14-171. While the functional significance of increases in “liver function tests” (LFTs) is unclear, a broad spectrum of histological changes including fatty infiltration [6, 9, 14, 15, 171, glycogen deposition [ 14, 151, and cholestasis [17] are reported to coincide with LFT abnormalities in adults. Among the proposed etiologies for such changes during TPN are excessive dextrose infusion [14, 15, 171, toxicity or imbalances of infused amino acids [6, 171, and concurrent essential fatty acid deficiency [ 111. A uniform finding among previous studies has been a temporal relationship of 1 to 3 weeks between the onset of parenteral feeding and the appearance of abnormal LFTs. This finding suggests that alterations in liver function and histology may be related to the rate of TPN infusion or to an excessive cumulative load of parenteral nutrition solutions. Parenteral Nutrition and Laboratory Methods