Clinical and biological changes in liver function during intravenous hyperalimentation.

The use of intravenous hyperalimentation (IVH) with 30% dextrose-amino acid solution produces prolonged positive nitrogen (N) balance, weight gain, and normal growth and development, with minimal metabolic complications. Several investigators have recently reported liver fatty metamorphosis with an associated increase in serum liver enzymes during IVH, particularly noticeable in premature infants. However, this effect has not been clearly defined in adult patients, especially in regard to the composition of the solution, the kcs:N ratio of the infused solution, and caloric requirements of the patient. A series of 42 patients were given a standard IVH formula (25% dextrose—4.5% crystalline amino acids) administered continuously through a central venous catheter whose tip was positioned in the superior vena cava. These patients were divided into 3 groups: Group I (27) who had no documented liver pathology. Group II (15) who had liver disease documented by liver biopsy or liver scan, and Group III (9) who we...