Parenteral nutrition brain

Brain enlargement and cerebral edema were observed upon autopsy of a boy who died after ingesting potassium dichromate (Kaufman et al. 1970). However, more chronic lower exposures to chromium(III) did not result in any somatopsychic changes in patients on total parenteral nutrition (TPN) solutions (Lovrincevic et al. 1996). In this study, the TPN patients were examined for somatopsychic responses. 

Martinez, M., and Ballabriga, A. (1987). Effects of parenteral nutrition with high doses of linoleaie on the developing human liver and brain. Lipids 22,133-138. 

The best way to monitor excessive exposure to manganese includes serum manganese concentration measurement in combination with brain MRI scanning and perhaps a battery of neurofunctional tests (7). Studies have concentrated on manganese in patients on parenteral nutrition (8) and occupational exposure (9). 

Acute hemiplegia and seizure developed in a 24-year-old patient following accidental catheterization of the right common carotid artery for parenteral nutrition infusion (16). Magnetic resonance imaging of the brain showed lesions in the frontal lobe and putamen, consistent with an ischemic stroke. 

A young man developed marked deterioration in his vision and oscillating vision, despite normal optic fundi, during parenteral nutrition he went on to develop a characteristic Wernicke s encephalopathy, confirmed by characteristic findings on MRI brain scan (42). The serum vitamin Bi concentration was 110 pg/ml (reference range 200-500). He responded fuUy to thiamine 300 mg/day in addition to betamethasone for 4 weeks. 

Stover JF, Kempski OS. Glutamate-containing parenteral nutrition doubles plasma glutamate a risk factor in neurosurgical patients with blood-brain barrier damage Crit Care Med 1999 27(10) 2252-6. 

Kafritsa Y, Fell J, Long S, Bynevelt M, Taylor W, MiUa P. Long-term outcome of brain manganese deposition in patients on home parenteral nutrition. Arch Dis Child 1998 79 263-5. 

Ono J, Harada K, Kodaka R, Sakurai K, Tajiri H, Takagi Y et al. Manganese deposition in the brain during long-term total parenteral nutrition. 

Alves G, Thiebot J, Tracqui A, et al. Neurologic disorders due to brain manganese deposition in a jaundiced patient receiving long-term parenteral nutrition. JPEN J Parenter Enteral Nutr 1997 21 41 5. 

Bertinet DB, Tinivella M, Balzola FA, et al Brain manganese deposition and blood levels in patients undergoing home parenteral nutrition. JPEN J Parenter Enterol Nutr 24 223-227, 2000... 

A few studies have reported increased blood and brain levels of the metal, either because of an inability to clear manganese due to chronic liver disease (Devenyi et al. 1994) or to an excess in parenteral nutrition... 

Children who suffer from cholestatic liver disease or who have gastrointestinal disorders that mandate they be given parenteral nutrition may be at increased risk from overexposure to manganese. Increased manganese concentrations in blood and brain, and symptoms of neuromotor dysfunction were observed in an... 

Is iodine insufficiency of current parenteral nutrition regimens potentially compromising the brain development of extreme and preterm infants when it is their only, or predominant, source of nutrition The determination of the iodide requirements of extreme preterm infants, and the safe levels of iodide supplementation necessary to achieve optimal blood levels, requires carefully piloted and designed clinical trials so that iodine toxicity is avoided. We have started this program of work (Ibrahim et al., 2003) and extended our knowledge through three further pilot studies in infants <30 weeks gestation. 

Natural diets will usually contain sufficient variety that such a low level of n-3 fat intake would be avoided. However, when the diet is limited to one food source such as when formulas are given to infants or in the case of parenteral nutrition, very low n-3 fatty acid intake becomes possible. In related studies in which nine groups of rats with varying levels of brain DHA were assessed for spatial task performance, it was observed that significant changes in performance could not be observed when the DHA level was more than 60% of the n-3 Adq level (47). Thus, the loss of 20% of brain DHA described in the human autopsy studies would probably not be expected to lead to spatial task performance losses. However, in many in-... 

The results of supplementary parenteral nutrition in twelve children between the ages of two to fourteen years with severe thermal injuries are reviewed. Ten of these patients suffered third degree burns involving 50 to 90% of the total body surface. One of the children with a 30%, burn had delayed healing due to severe malnutrition prior to his transfer to this hospital, i.e., loss of 50%. of body weight. Another, four year old patient with 30% burns suffered anoxic brain damage and was unconscious for a period of six weeks. 

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