Objective Hepatic failure secondary to standard total parenteral nutrition (TPN) has a high mortality in short gut patients. Fat in TPN is a co-factor in the development of hepatic failure. We report on six cases managed with fat-reduced TPN and their outcomes. The new TPN regime consisted of a maximum of 1.5 g/kg per day of fat in the solution.

Methods The records of patients placed on the new regime were retrieved. Liver function tests, electrolytes, septic episodes, weight gain and length of follow-up were recorded. The median for each variable was calculated.

Results The results are summarised in the table. Six infants were included in the study (three males, three females). Five had short gut and the sixth (patient 6) had intestinal surgery. All five patients with short gut underwent reconstructive surgery.

Conclusion Fat-reduced TPN is a safe option in the management of short gut patients. It preserves liver function and can act as a rescue regimen in selected patients with deranged liver functions due to standard TPN.