Safety and efficacy of glycerol and amino acids in combination with lipid emulsion for peripheral parenteral nutrition support.
The safety and efficacy of administering lipid emulsion with ProcalAmine, a glycerol-based parenteral nutrition solution, for peripheral nutrition has not been previously studied. Thirty-four patients recovering from major trauma or surgery were studied while receiving a peripheral parenteral nutrition regimen of either ProcalAmine with 10% lipid emulsion (group 1) or ProcalAmine with 20% lipid emulsion (group 2) for up to 5 days postinjury. Daily dose was 45 mL/kg ProcalAmine, providing 1.35 g of amino acids/kg and 1.35 g of glycero/kg, and 500 mL/day lipid emulsion. The mean daily nitrogen balance was -0.3 g/day in group 1 and -4.1 g/day in group 2. There was no progressive accumulation of circulating glycerol, and urinary glycerol excretion was minimal (less than 0.2 g/day), indicating effective utilization of glycerol as an energy substrate. Our finding that nitrogen balance was better with 10% fat emulsion suggests a limitation in fat utilization in this setting. Both regimens were well tolerated; there were no adverse clinical reactions and no occurrences of phlebitis in either group.
Waxman
K
K
Department of Surgery, University of California Irvine Medical Center, Orange 92668.
Day
A T
AT
Stellin
G P
GP
Tominaga
G T
GT
Gazzaniga
A B
AB
Bradford
R R
RR
D000293:Adolescent; D000328:Adult; D000596:Amino Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D004573:Electrolytes / Q000008:administration & dosage / Q000627:therapeutic use; D002149:Energy Intake; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005990:Glycerol / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism; D010288:Parenteral Nutrition; D011182:Postoperative Care; D012996:Solutions; D014947:Wounds and Injuries / Q000628:therapy
D000596:Amino Acids; D004573:Electrolytes; D005217:Fat Emulsions, Intravenous; D012996:Solutions; C052903:ProcalAmine; D009584:Nitrogen; D005990:Glycerol