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Safety and Efficacy of Glycerol and Amino Acids in Combination With Lipid Emulsion for Peripheral Parenteral Nutrition Support

Department of Surgery, University of California Irvine Medical Center, Orange, California

Audrey T. Day, RN, MA

Department of Surgery, University of California Irvine Medical Center, Orange, California

Gianna P. Stellin, MD

Department of Surgery, University of California Irvine Medical Center, Orange, California

Gail T. Tominaga, MD

Department of Surgery, University of California Irvine Medical Center, Orange, California

Alan B. Gazzaniga, MD

Department of Surgery, University of California Irvine Medical Center, Orange, California

Ronald R. Bradford, RPH

McGaw, Inc, Irvine, California

The safety and efficacy of administering lipid emulsion with ProcalAmine, a glycerol-based parenteral nutrition solution, for peripheral nutrition has not been previously studied. Thirty-four patients recovering from major trauma or surgery were studied while receiving a peripheral parenteral nutrition regimen of either ProcalAmine with 10% lipid emulsion (group 1) or ProcalAmine with 20% lipid emulsion (group 2) for up to 5 days postinjury. Daily dose was 45 mL/kg ProcalAmine, providing 1.35 g of amino acids/kg and 1.35 g of glycerol/kg, and 500 mL/day lipid emulsion. The mean daily nitrogen balance was -0.3 g/day in group 1 and -4.1 g/day in group 2. There was no progressive accumulation of circulating glycerol, and urinary glycerol excretion was minimal (<0.2 g/ day), indicating effective utilization of glycerol as an energy substrate. Our finding that nitrogen balance was better with 10% fat emulsion suggests a limitation in fat utilization in this setting. Both regimens were well tolerated; there were no adverse clinical reactions and no occurrences of phlebitis in either group. (Journal of Parenteral and Enteral Nutrition 16:374-378, 1992)

Journal of Parenteral and Enteral Nutrition, Vol. 16, No. 4, 374-378 (1992)
DOI: 10.1177/0148607192016004374


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