Parenteral feeding in a patient with hypertriglyceridemia and increased liver enzyme levels.
OBJECTIVE
To discuss nutritional support in a patient with hypertriglyceridemia and liver dysfunction.


METHODS
We describe the hospital course of a critically ill patient with hepatic dysfunction and hypertriglyceridemia who required nutritional support, and we provide an overview of lipid metabolism.


RESULTS
A 27-year-old man with hepatic dysfunction and hypertriglyceridemia, who had undergone kidney transplantation 4 months previously, was admitted to the intensive-care unit with upper gastrointestinal bleeding. He was unable to tolerate enteral feeding, and central parenteral nutrition was initiated. Calories from dextrose and fat were limited because of the presence of increased liver enzyme levels and hypertriglyceridemia. A modified regimen of parenteral nutrition was developed for the patient. The short-term reduction of total calories to 75% of the predicted need is safe.


CONCLUSIONS
Nutritional support in patients with liver dysfunction and hypertriglyceridemia is complicated and may require temporary underfeeding because of the need to limit fat and dextrose intake.
Leung
N
N
Mayo Graduate School of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
O'Brien
T
T
McMahon
M M
MM