Hyperalimentation

Parenteral hyperalimentation involves administration of large amounts of nutrients (e.g., carbohydrates, amino acids, lipids, and vitamins) to maintain a patient who is unable to take food orally for several weeks at caloric intake levels of 4000 kcal/day or more. Earlier methods of parenteral alimentation, which involved IV... 

Parenteral nutrition (PN) provides macro- and micronutrients by central or peripheral venous access to meet specific nutritional requirements of the patient, promote positive clinical outcomes, and improve quality of life. PN is also referred to as total parenteral nutrition or hyperalimentation. 

Acid ingestion (ammonium chloride, hydrochloric acid, hyperalimentation)... 

Phosphorus, 12 to 15 mmol/L, should be routinely added to hyperalimentation solutions to prevent hypophosphatemia. 

In 1978, on the basis of a few measurements of urine calcium and phosphate excretion as well as an awareness of the previously mentioned work regarding the amounts of calcium and phosphate normally accreted in utero and postnatally, it became apparent that the demineralization, fractures and rickets we were seeing in our infants were caused by calcium deficiency. Consequently we increased the amount of calcium added to the parenteral alimentation solutions. If more than 12.5 mM of the calcium were added to a liter of hyperalimentation solution, gross precipitation would occur in the feeding solution. If 10 mM of calcium were added per liter, crystalline precipitated began to build up on the inside of our barium-impregnated silicone rubber central venous catheters. This crystalline precipitate resulted in gradual occlusion and functional loss of these lines. After several false starts and six lost catheters, chemical and crystal analysis showed that the precipitate inside these catheters was CaHPO. ... 

Figure 3. Interaction among pH, calcium, and phosphate in hyperalimentation solutions. The pH, calcium values to the right of phosphate isoconcentration curves are associated with precipitation of dibasic calcium phosphate, while pH, calcium values to the left of phosphate isoconcentration curves are associated with solubility of calcium and phosphates in hyperalimentation solution.

When large volumes (i.e., more than a liter) of fluid are injected (such as in peritoneal dialysis, hyperalimentation, fluid replacement, and other conditions). Special consideration of fluid balance must be given to patients receiving large volumes, as well as careful consideration of the systemic effects of injection fluid components (e.g., amino acids and their nephrotoxicity). 

The present chapter deals with calculations associated with calories, nitrogen, protein-calorie percentage, parenteral hyperalimentation, and resting energy expenditure (REE) calculations including REE assessments for geriatric and pediatric populations. 

A hyperalimentation order for a patient includes 30 mg of amphotericin B, 50 units of heparin, 25 mEq of potassium acetate, and 1.5 mg of folic acid... 

Hyperalimentation - Maintenance requirements are not precisely known. Maintenance dose range ... 

Severe negative nitrogen balance may occasionally have to be corrected by hyperalimentation or total parenteral nutrition (TPN). Intravenous solutions used in TPN contain essential and nonessential amino acids, plus a source of calories in the form of fat and carbohydrate. They "spare" the administered amino acids and allow them to be used for tissue repair. The TPN fluid must also contain all other nutritional factors required for life, including essential fatty acids, vitamins, and minerals. Severe metal and essential fatty acid deficiencies have been observed in situations in which such inclusions had not been made. 

The organic acid analysis in the urine of this child was consistent with biotin deficiency or multiple carboxylase deficiency. Biotin deficiency usually can be excluded unless there is a history of dietary indiscretion, such as consuming a diet containing raw eggs or few biotin-containing foods, or there is a history of prolonged parenteral hyperalimentation without biotin supplementation. Low serum biotin concentrations can be useful in differentiating... 

Serum biotinidase activity is not altered by biotin deficiency. This was demonstrated by finding normal serum biotinidase activity in several patients who became biotin deficient while being treated with parenteral hyperalimentation lacking biotin. Biotinidase appears to play an important role in the processing of protein-bound biotin, either by being secreted into the intestinal tract, where it can release biotin from... 

Based upon clinical data we have reclassified zinc deficiency using traditional, epidemiological techniques into three syndromes these are acute, chronic and subacute zinc deficiency. Acute zinc deficiency is relatively uncommon and follows parenteral hyperalimentation or oral L-histidine administration. Chronic... 

Copper deficiency in human subjects recently has been reviewed by Graham and Cordano (9). Previously it has been widely accepted that copper deficiency in man does not occur (63), but recent evidence indicates that its presence is prevalent in untreated malnourished infants (64) and in infants fed low copper-milk diet (65,66). In addition, copper deficiency has been described in premature infants (67), in malnourished children during hyperalimentation (68,69), and in adults (70, 71,72),... 

Takamura A, Ishii F, Noro S, et al. Study of intravenous hyperalimentation effect of selected amino acids on the stability of intravenous fat emulsions. / Pharm Sci 1984 73 91-94. 

Patients receiving hyperalimentation fluid containing proline may show an increase of 0.2 mg/dl. 

Parenteral route, which provides high-calorie nutrients administered through large veins such as the subclavian vein. This process is called total parenteral nutrition (TPN) or hyperalimentation. Parenteral is expensive, has a high rate of infection, and does not promote GI function, liver function, or weight gain. 

Another name for parenteral nutritional support therapy is total parenteral nutrition (TPN) or hyperalimentation. 

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