[Role of total parenteral nutrition in determining liver insufficiency in patients with cranial injuries. Glucose vs glucose + lipids].
Total parenteral nutrition (TPN) rich in glucose may cause a deposition of triglycerides in the liver with consequent steatosis. We have valued the role of different nutrients in the determinism of liver failure. Sixty-five patients with severe and isolated head trauma (GCS score of 7 or less), 50 men and 15 women, of mean age 28 years (range: 15-68 years) were prospectively studied. All patients have a negative history for liver disease. In 24 randomly selected patients only glucose (group G) was administered as non-protein caloric source, while other 41 patients received glucose and Intralipid 10% (group GL) in ratio 70:30. The global incidence of cholestasis was 52.3% (34 patients): 17 patients (70.8%) of the group G and other 17 patients (41.5%) of the group GL (less than 0.025). No significant differences regarding the day of beginning of the cholestasis, the duration of TPN and the mean caloric and protein supply were pointed out. The liver steatosis was observed in 10 cases: 8/15 (53.3%) of the group G and 2/12 (16.7%) of the group GL (p 0.05). In conclusion, a TPN with glucose plus lipids is least toxic for the liver than only glucose.
Zagara
G
G
Locati
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000628:therapy*; D056486:Chemical and Drug Induced Liver Injury; D002779:Cholestasis / Q000139:chemically induced*; D004655:Emulsions; D005217:Fat Emulsions, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D005234:Fatty Liver / Q000209:etiology; D005260:Female; D005947:Glucose / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D010743:Phospholipids; D011897:Random Allocation; D013024:Soybean Oil
D004655:Emulsions; D005217:Fat Emulsions, Intravenous; D010743:Phospholipids; C545823:soybean oil, phospholipid emulsion; D013024:Soybean Oil; D005947:Glucose
Ruolo della nutrizione parenterale totale nel determinismo dell'insufficienza epatica nei traumatizzati cranici. Glucosio vs glucosio + lipidi.