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Dear all, We have a case of a long-term TPN patient who has developed liver impairment and is awaiting a biopsy for investigation. We want to rule out TPN as a cause but all of the usual steps of fat free nights / longer feeding time etc have failed to improve the liver function. The next proposal is to have a complete break from lipid for a few months however we are concerned about the risk of developing essential fatty acid deficiency. Does anyone have any experience / literature about how long it would take for a deficiency to develop? Any alternative suggestions as to how to replace fatty acids would be welcome, the patient does not have enough distal bowel for oral replacement but there was some talk of potential for skin creams? I would also be interested to hear if any labs have a protocol for this situation they would be willing to share? Thanks Jen Jennifer Glaysher Senior Clinical Biochemist Aintree University Hospitals NHS Trust Longmoor Lane L9 7AL Phone: 0151 529 3990 ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/