Total parenteral nutrition in the

Hermann M, Bretscher R, Thi baud G et al 1990 Preliminary experiences with the treatment of shock in horses with a plasma expander from a starch base. Schweizer Archiv fur Tierheilkunde 132 5-12 Heyland D K, MacDonald S, Keefe L et al 1998 Total parenteral nutrition in the critically III patient a metaanalysis. Journal of the American Medical Association 280 2013-2019... 

Total Parenteral Nutrition in the Newborn 265 Table II. Endogenous Fuel Composition of Man... 

Total Parenteral Nutrition in the Newborn Table III. Diagnosis of Infants Receiving TPN in the Neonatal Intensive Care Unit at the Hospital for Sick Children (Toronto) During 6 Mo of 1982 ... 

In summary, total parenteral nutrition in the beagle puppy provides a useful tool in which further to examine the consequences of taurine-deficient diets during development. These data suggest that the hepatic taurine pool is the pool most rapidly depleted during taurine deficiency. Hepatic CSAD activity in the beagle is increased in response to a taurine-deficient diet, but this response is not... 

The Veteran Affairs Total Parenteral Nutrition Cooperative Study Group. Perioperative total parenteral nutrition in surgical patients. N Eng J Med 1991 325 525-532. 

Rollins C, Thomson C, Crane T. Pharmacotherapeutic issues. In Rolandelli RH, Bankhead R, Boullata JI, Compher CW, eds. Enteral and Tube Feeding. 4th ed. Philadelphia Elsevier 2005 291-305. van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. New Engl J Med 2001 345 1359-1367. Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. Perioperative total parenteral nutrition in surgical patients. New Engl J Med 1991 325 525-532. 

Steger, P. J. K., and Mtihlebach, S. F. (2000), Lipid peroxidatoin of intravenous lipid emulsions and all-in-one admixtures in total parenteral nutrition bags The influence of trace elements, J. Parenteral Enteral Nutr., 24, 37M1. 

Leung FY, Galbraith LV. Elevated serum chromium in patients on total parenteral nutrition and the ionic species of contaminant chromium. Biol Trace Elem Res 1995 50 221-8. 

Total parenteral nutrition is the most extreme form of nutritional support and can give rise to considerable dilTiculties. In order to pre-empt these, ctmsistent... 

In the only study that has investigated total parenteral nutrition in infants, intakes of 150ml/kg/day, with no enteral component, suppfied a mean iodide intake of... 

In order to insure maximum safety to the patient, it is strongly recommended that any institution in which intravenous hyperalimentation is practiced should have a designated and qualified hyperalimentation or total parenteral nutrition team. The minimum team should consist of an attending physician who is well versed in nutrition and metabolism, a conscientious and interested house officer or research fellow, a pharmacist trained in aseptic solution formulation, and a technician or nurse. Other members of a complete hyperalimentation team include a nutritionist, clinical pathologist or biochemist, physical therapist, sociologist, and psychiatrist. 

Of special interest in this group of youngsters has been the response of severe rectal and perianal disease to total parenteral nutrition. In one boy (R.G.) who failed to respond to several operations, his upper intestinal tract remission has been accompanied by complete healing of multiple perianal fistulae. In the girl (M.P.) who had an ileocolectomy and post operative parenteral nutrition, multiple perianal fistulae have healed. In this patient the effect of resection of intra-abdominal disease must be considered, but the rapidity of the perineal improvement was similar to that noted for R.G. Lastly, I.W. with severe anal granulomata and ulcers sustained marked improvement of the anal involvement after a brief course of parenteral alimentation. 

One of the most confusing aspects of total parenteral nutrition involves its effect on hepatic function. A ntunber of patients develop elevations of serum transaminases (SCOT and SGPT) during the course of total parenteral nutrition. In most instances these elevations are transient and are not accompanied by other signs of deranged hepatic function (Heird, W. C., t l., 1972). However,... 

The term hyperalimentation alone literally means the provision of nutrients at levels considerably higher than those received in a normal diet, although in medical circles it is commonly used as a synonym for total parenteral nutrition (TPN). The latter procedure involves the provision of all... 

Taurine deficiency can be created in man under other circumstances. In infants fed total parenteral nutrition, in which the amino acid solution does not contain taurine, the concentration of taurine in the plasma and urine decreases (Rigo and Senterre, 1978). 

Biomedical Uses. The molybdate ion is added to total parenteral nutrition protocols and appears to alleviate toxicity of some of the amino acid components in these preparations (see Mineral NUTRIENTS) (97). Molybdenum supplements have been shown to reduce iiitrosarnine-induced mammary carcinomas in rats (50). A number of studies have shown that certain heteropolymolybdates (98) and organometaUic molybdenum compounds (99) have antiviral, including anti-AIDS, and antitumor activity (see Antiviral agents Chemotherapeutics, anticancer). 

Panthenol is frequently used in ointments and solutions for the treatment of burns, anal fissures, and inflammation of the conjunctiva. The vitamin has to be substituted in patients on total parenteral nutrition and in those who regularly undergo dialysis. Hypervitamin-osis has not been observed for doses up to 5 g/d (22). Furthermore, the administration of pantothenic acid leads to improved surgical wound healing due to its antiinflammatory properties. 

The composition of body fluids remains relatively constant despite the many demands placed on the body each day. On occasion, these demands cannot be met, and electrolytes and fluids must be given in an attempt to restore equilibrium. The solutions used in the management of body fluids discussed in this chapter include blood plasma, plasma protein fractions, protein substrates, energy substrates, plasma proteins, electrolytes, and miscellaneous replacement fluids. Electrolytes are electrically charged particles (ions) that are essential for normal cell function and are involved in various metabolic activities. This chapter discusses the use of electrolytes to replace one or more electrolytes that may be lost by the body. The last section of this chapter gives a brief overview of total parenteral nutrition (TPN). 

When normal enteral feeding in not possible or is inadequate to meet an individual s nutritional needs, intravenous (IV) nutritional therapy or total parenteral nutrition (TPN) is required. Products used to meet the IV nutritional requirements of the patient include protein substrates (amino acids), energy substrates (dextrose and fat emulsions), fluids, electrolytes, and trace minerals (see the Summary Drug Table Electrolytes). 

It is common practice to discontinue oral feedings during an attack of acute pancreatitis. In theory, discontinuation of oral intake will decrease the secretory functions of the pancreas and minimize further complications from the disease. Some patients can be fed with minimal oral intake. Tube feeding delivered via a nasojejunal tube will feed the patient beyond the ampulla of Vater, minimizing stimulation of the pancreas.15,16 If oral intake is discontinued for a protracted period, total parenteral nutrition must be used to maintain adequate nutrition.17,18... 

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