The effect of short-term total parenteral nutrition on hepatic function in the human neonate: A prospective randomized study demonstrating alteration of hepatic canalicular function

Twenty-one infants who were candidates for TPN because of respiratory disease were randomized into experimental (TPN) and control (glucose-electrolyte) groups. Serum GOT, GPT, GGTP, 5′ nucleotidase, total, direct, and conjugated (ethyl anthranilate-reactive) bilirubin, and bile salt concentrations were determined at entry into the study and at one week. One week of TPN caused significant elevations of GGTP, 5′-N, and EA bilirubin values, whereas SGOT, SGPT, SBS, and total and direct bilirubin were unaffected. Addition of a lipid infusion to TPN did not alter these differences. These data are interpreted as showing: (1) amino acid infusion has an early effect on hepatic function which is independent of the many diseases for which this therapy is used and of the concomitant use of lipid; (2) the initial effect appears to be on the canalicular membrane; and (3) the sinusoidal membrane is apparently unaffected by one week of TPN.