Absence of the biochemical symptoms of essential fatty acid deficiency in surgical patients undergoing protein sparing therapy.

The biochemical symptoms of essential fatty acid deficiency appear within 7 to 10 days of fat-free total parenteral nutrition using glucose-amino acid mixtures. The linoleic acid (C18:2W6) content of all plasma lipid fractions decreases greatly and plasma eicosatrienoic acid (C20:3W9) increases. We have measured the fatty acid composition of the plasma lipid fractions in six surgical patients receiving parenteral nutritional solutions containing only amino acids, and completely free of glucose, before and after 10 to 14 days of such therapy. Biochemical symptoms of essential fatty acid deficiency did not occur. The fatty acid composition of all plasma lipid fractions remained unchanged after this time period. Mobilization of linoleic acid from the adipose tissue occurred with this treatment in contrast to the inhibition of lipolysis of adipose tissue triglyceride produced by continuous infusions of hypertonic glucose-amino acid mixtures.