Short-term administration of parenteral glucose-lipid mixtures improves protein kinetics in portacaval shunted rats.

The efficacy of various total parenteral nutrition regimens administered for 72 h in supporting the rat after portacaval anastomosis was evaluated. All animals that received amino acid-containing formulas had significantly improved nitrogen balance (p less than 0.05), albumin synthetic rates (p less than 0.05), and serum albumin concentration (p less than 0.05) compared with animals receiving dextrose only. Rats that received the mixed-fuel system containing amino acids, dextrose, and lipid had significantly improved leucine flux and whole body protein synthesis (p less than 0.05) compared with animals that received dextrose only, or amino acids and dextrose. Diets composed of dextrose only, amino acids and dextrose, or amino acids and dextrose with the addition of currently available long-chain triglyceride lipid emulsion induced abnormal morphologic changes in the liver. No hepatic morphologic changes were evident in rats that received an isocaloric mixed-fuel regimen containing medium- and long-chain triglycerides. The results suggest that mixed-fuel systems containing amino acids and dextrose with lipids are superior to formulas containing dextrose only, or dextrose with amino acids. The improved liver morphology observed in animals given the lipid emulsion system containing medium- and long-chain triglycerides suggests that medium-chain triglycerides may provide an additional benefit in supporting the patient with liver dysfunction.