Total body water changes during high volume peripheral hyperalimentation.

A premature baby with gastroschisis, ileal atresia and secondary short gut syndrome was sustained with the use of peripheral hyperalimentation consisting of 2 per cent Amigen, 12 per cent glucose and 10 per cent Intralipid at an average rate of 140 to 160 milliliters per kilogram per day or 100 to 111 kilocalories per kilogram per day. The weight of the child increased during the first four months to approximately 14 grams per day, with body length increasing by about 6 millimeters per week. Six reliable measurements of the total body water of the child during the four month period were obtained using deuterium oxide dilution followed by double vacuum distillation and falling drop analysis in a constant temperature chamber. Measurements obtained showed a gradual decrease of total body water from 77.13 per cent of body weight to 60.50 per cent during the study period, with values consistently on the lower end of the spectrum of known normal controls, even during periods of increased growth rates of as much as 35 grams per day. These data on total body water, coupled with the observed gains in body weight and length, support tissue accretion rather than fluid retention as the mechanism of weight gain in long term, high volume peripheral hyperalimentation.