Parenteral nutrition by peripheral vein, portal vein or central venous catheter?
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to A Bodoky.
Explore the source record for details and available documents.
Research in absorption physiology requires animal models which closely resemble the in vivo situation. The description of a new canine model satisfying these requirements is the objective of this report. Dogs were instrumented with indwelling portal vein and carotid artery catheters, a catheter jejunostomy and an electromagnetic flow measuring probe around the portal vein enabling continuous flow recordings. Following intrajejunal infusion of nutritive substrates in the conscious animal, absorption was measured as the product of porto-arterial substrate difference and portal venous flow. The model was validated in five mongrel dogs: (1) Catheters and flow measuring device function over several months. (2) The sensitivity of the method was evaluated following intrajejunal infusion of l-glycine-l-tyrosine and its constituent amino acids. A significant portoarterial concentration difference of both amino acids enabling quantitative measurement of absorption resulted when the peptide was infused at 4 mmoles/hour (20 mM solution, 200 ml/h). (3) Infusion of complete nutritive formulas caused a significant increase in portal venous flow whereas neither saline nor the amino acids or the peptides investigated had a comparable effect. (4) A validation experiment by implantation of a second flow probe distal to the chronically implanted device provided evidence that granulomatous tissue forming around the probe does not alter the accuracy of the flow recording. In summary, this method permits for the first time quantitative measurement of absorption by appearance rates in portal venous blood instead of by disappearance from the intestinal lumen.
Needle catheter jejunostomy is used to a varying extent today. Therefore, the need for nutritional support was evaluated following elective abdominal surgery and compared to experiences with postoperative enteral feeding. Oesophagectomy, total gastrectomy and the Whipple procedure were identified as good indications for catheter jejunostomy, whereas with other types of operation an individual decision is required.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Basic nutrition solutions become ever more important in postoperative infusion therapy. We tested the peripheral venous tolerance of an infusion solution which included aminoacids and carbohydrates (1100 mosm/l, 2400 kJ/l). We compared the peripheral venous tolerance of this nutrition solution with those commonly used in hospitals (Ringer-solution 330 mosm/1, 5% glucose solution 280 mosm/l 800 kJ/l, electrolyte glucose solution 407 mosm/l 800 kJ/l). The infusion thrombophlebitis was examined on 30 patients with the radiojodfibrinogen test. Despite three times higher osmolarity the peripheral nutrition solution shows no difference in peripheral venous tolerance after 48 hours.
Explore the source record for details and available documents.