Effects of intravenous lipid as a source of energy in parenteral nutrition associated hepatic dysfunction and lidocaine elimination: a study using isolated rat liver perfusion
✍ Scribed by Nuzhat Zaman; Yun K. Tam; Lawrence D. Jewell; Ronald T. Coutts
- Publisher
- John Wiley and Sons
- Year
- 1997
- Tongue
- English
- Weight
- 245 KB
- Volume
- 18
- Category
- Article
- ISSN
- 0142-2782
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✦ Synopsis
The eects on liver function and hepatic lidocaine elimination using 20% Intralipid 1 as a source of non-protein calories (30%) in parenteral nutrition were studied using an isolated rat liver perfusion procedure. Rats were randomly assigned to one of the three treatment groups: PNL group (n = 6), consisting of 16´94% dextrose, 2´46% Intralipid 1 , and 5´2% amino acids; PN group (n = 5), consisting of 24´2% dextrose and 5´2% amino acids; and CF group (n = 6), chow fed (rat chow and water). The rate of lidocaine metabolism was signi®cantly reduced after 7 d in the two PN treated groups when compared to CF. Steatosis was observed in ®ve out of six PNL treated animals and two out of ®ve PN treated animals. Intrinsic clearance was reduced by 80% in the PNL group and by 60% in the PN animals ( p<0´05). Molar metabolite to drug ratios revealed signi®cant reductions in N-dealkylation, m-hydroxylation, and aryl methyl hydroxylation in groups PNL and PN; these values amounted to 67±92% ( p<0´05). These ®ndings suggest that a dextrose±amino acid solution induced steatosis and reduced the rate of lidocaine metabolism. The incorporation of Intralipid 1 caused further deterioration. &1997 John Wiley & Sons, Ltd.