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

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)