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Hepatic Dysfunction During Hyperalimentation
George F. Sheldon, MD;
Scott R. Petersen, MD;
Richard Sanders, MD
Arch Surg. 1978;113(4):504-508.
Abstract
• Liver biopsy specimens were studied in 26 patients in whom liver function abnormalities developed during intravenous hyperalimentation (IVH). The clinical manifestations and duration of IVH were evaluated in relation to the morphological changes seen in the liver.
Early hepatic changes consisted of fatty metamorphosis, and progressive intrahepatic cholestasis developed as IVH was continued. Essential fatty acid deficiency, amino acid imbalance, caloric excess, and toxic manifestations of certain amino acids are postulated as causative factors. The hepatic steatosis secondary to IVH may be treated by lowering the dextrose concentration of the infusion or by administering dextrose-free amino acid solutions. The clinical importance of this common complication of IVH is the difficulty in distinguishing it from other causes of cholestasis in seriously ill patients.
(Arch Surg 113:504-508, 1978)
Author Affiliations
From the Department of Surgery (Dr Sheldon) and the Trauma and Hyperalimentation Unit (Drs Sheldon, Petersen, and Sanders), University of California at San Francisco General Hospital, San Francisco.
Footnotes
Read before the 85th annual meeting of the Western Medical Association, Las Vegas, Nov 16, 1977.
Reprint requests to Department of Surgery, San Francisco General Hospital, San Francisco, CA 94110 (Dr Sheldon).
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