Advances in Parenteral Nutrition: Proceedings of an International Symposium Held in Bermuda, 16–19th May, 1977I.D.A. Johnston Parenteral nutrition has been one of the most significant therapeutic advances of the past twenty years. Many patients have survived very serious illness only because of intravenous nutrition for either short or very long periods of time. The indications for parenteral nutrition are simple and can be summarised as the inability to ingest necessary nutrients for a significant time during increased metabolic demands. Many problems in the preparation of energy sources and amino acid solutions have been solved so that the time is opportune to review what has been achieved and discuss recent advances and current thinking in the light of future requirements. The next phase in parenteral nutrition will undoubtedly be the provision of regimens designed for specific situations. The needs of the neonate for example are known to differ from adult requirements. The choice of carbohydrate for intravenous use has been a matter of much of glucose both in biochemical and clinical terms discussion. The supremacy now seems well established. The value of intravenous fat is well documented, but the interchange of fat and carbohydrate as calorie sources and the effects of prolonged infusions of fat merit further investigation. The evidence that isotonic amino acids are utilized effectively when given alone due to the availability of endogenous energy sources has led to a greater understanding of the metabolic changes and demands associated with injury and sepsis. |
Contents
Metabolic foundations of intravenous nutrition | 3 |
Some general considerations concerning the use of carbohydrates | 23 |
Metabolic pathways for carbohydrates in parenteral nutrition | 29 |
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Advances in Parenteral Nutrition: Proceedings of an International Symposium ... I.D.A. Johnston No preview available - 2014 |
Common terms and phrases
acidosis administration alanine albumin alimentation amino acid infusion amino acid solutions bacteria biochemical Blackburn blood body cell mass body composition body weight calories Candida carbohydrate catabolism catheter Clin clinical complications concentration contamination depletion dextrose disease Dudrick effect electrolytes elemental diet energy excretion fat emulsions Figure fistula fluid fructose gastrointestinal gluconeogenesis glucose hospital hydrolysate hyperalimentation hypophosphataemia increased infants infection injury insulin intake intestinal intracellular Intralipid intravenous feeding intravenous nutrition isotonic amino acid ketone bodies lactate lean body mass levels lipid liver malnutrition measured metabolism mmol/l muscle neonates nitrogen balance normal nutrients nutritional support operation oral patients receiving peripheral phenylalanine phosphate plasma post-operative protocol renal sepsis septic septicaemia serum skin small bowel sorbitol starvation studies substrate Surg surgery surgical Synthamin Table tissue total parenteral nutrition TPN therapy trace elements Travasol tryptophan urinary utilization Vamin venous weight loss Wilmore xylitol zinc