Abnormalities of Liver Function during Total Parenteral Nutrition (TPN): Alteration of Serum Liver Enzyme during Short-term TPN.
- Author:
Tae Hyun KIM
1
;
Kyung Hyun CHOI
;
Ki Young YOON
;
Kyung Won SEO
;
Dae Woo YOO
;
Won Geun KANG
;
Dong Won RYU
;
Kyoung Chun LEE
;
Eun Ae JUNG
;
Sun Gye LIM
;
Hong Seon KIM
;
Kum Sook LEE
;
Eun Sil KIM
;
Su Mi AHN
Author Information
1. Department of Surgery, Kosin University, Gospel Hospital, Busan, Korea. kitah@korea.com
- Publication Type:Original Article
- Keywords:
Total parenteral nutrition;
Abnormalities of liver function
- MeSH:
Adult;
Bilirubin;
Drug Therapy;
Humans;
Incidence;
Liver Function Tests;
Liver*;
Parenteral Nutrition;
Parenteral Nutrition, Total*;
Retrospective Studies;
Risk Factors;
Stomach Neoplasms
- From:Journal of the Korean Surgical Society
2002;63(5):409-415
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: TPN has been widely used to treat nutritional depletion since the late 1960s. However, many metabolic complications may occur as a result of parenteral feeding. Among these, hepatic complications has received increasing attention. A retrospective review of liver function abnormalities in adult patients who underwent TPN was done to determine the frequency and magnitude of the abnormalities in a liver function test. METHODS: From January 2001 to Jun 2001, 160 adult patient receiving TPN were reviewed. Of these, 111 had a malignant disease and 49 had a benign disease. The duration of TPN therapy ranged from 5 days to 52 days, with a mean duration of 14 days. Abnormalities of liver function test were defined as a value greater than the upper normal limit. Forty cases of gastric cancer were analyzed to determine the risk factors that contribute to abnormal liver function in individual patients receiving TPN. RESULTS: Abnormalities of the liver function test appeared after 6~7 days of therapy. Increases in the ALP levels were noted in 34 out of 93 patients (37.6%), in the AST levels in 42 out of 116 patients (36.2%), in the ALT levels in 54 out of 125 patients (43.2%), in the LDH levels in 20 out of 72 patients (27.8%), in the gamma-GTP levels in 44 out of 81 patients (54.3%), and in the bilirubin levels in 30 out of 126 patients (23.8%). The serum ALP level rose to 1.6 times upper the limit of normal; AST, 1.7 times; ALT, 2.0 times; LDH, 1.2 times; gamma-GTP, 2.4 times; bilirubin, 2.4 times. gamma-GTP value was most sensitive. In 40 gastric cancers, factors as age, the amount of TPN solution, the duration of TPN, intraoperative chemotherapy, transfusion, and postoperative infection were investigated. However, no association with TPN-associated liver function abnormalities was found. CONCLUSION: The incidences of an abnormal liver function during TPN were 23.8~54.3%. However, the liver function abnormalities that developed during short term-TPN were reversible and not serious.
