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At least 19 recordsLinked to original sources
PubMed1977

[The use of sugar substitutes in parenteral feeding].

Parenteral administration of hydrocarbons is particularly indicated after heavy trauma or operations. In this case, fructose and the sugar substitutes sorbitol and xylitol play an important role as they can be metabolized independently from insulin. In this comprehensive review, the objectives and goals of parenteral nutrition as well as the metabolic processes of sugar substitutes in the human organism and their effects and the tolerances are discussed.

Amino Acids↗
PubMedDate not supplied

[Candida infections and their evolution in patients receiving parenteral feeding].

Parenteral nutrition has completely modified the prognosis in a variety of illnesses of digestive tract. The method is not devoid of complications, and septicemias, particularly those originated by fungii of the Candida species, have been informed to occur with an alarming frequency of up to 23%. The patient on parenteral nutrition is an ideal prey for this kind of infection, but if the technic and the metabolic control are brought down considerably. In 30 patients of the Department of Gastroenterology at the Hospital General, Centro Médico Nacional, Instituto Mexicano del Seguro Social, we have studied the frequency and evolution of Candida infections, detected before or during the treatment with parenteral nutrition to know the influence of the method on this type of host-parasite relationship. In the initial cultures 60% of the patients develop Candida in one or several regions; percentage increased to 63.3% at the end of 15 days and decreased spontaneously to 33% at the end of the treatment on the 30 patients we did not observe a septicemia due to Candida. We conclude that parenteral nutrition, while correcting the nutritional state of the patient, with a good technic, favors the spontaneous withdrawal of the fungii, without the necessary specific treatment.

Candidiasis↗
PubMed1977

[Parenteral feeding. Prevention of complications in adults during exclusive mid-term parenteral feeding].

The benefits of parenteral feeding need no longer be emphasised. However, qualitative and quantitative food supplements raise a certain number of difficulties which should be better known. Infection is the most frequent complication. It may be avoided by strict aseptic precautions throughout parenteral feeding. Hypoglycemia is a major risk owing to the possible consequence. Hyperglycemia and its consequence of osmotic polyuria is more frequent and should be controlled to avoid loss of water and salt. Complications due to the use of lipid emulsions are exceptional when soya oil is used. Hypophosphoremia should be corrected by increasing phosphate intake. Hypocalcemia is common; it is often associated with hypoproteinemia and sometime a low calcium intake, vitamin D deficiency or a sudden increase in phosphate intake. Vitamin deficiencies, hypomagnesemia, and oligo-element deficiencies should be correcty by appropriate supplements.

Acid-Base Imbalance↗
PubMed1982

Necrotising enterocolitis in the very low birthweight infant: expressed breast milk feeding compared with parenteral feeding.

The incidence of necrotising enterocolitis (NEC) in very low birthweight infants (VLBW less than or equal to 1500 g) was reduced by the delayed onset of enteral feeding. Eight (18%) out of 44 VLBW infants who were in hospital during the first year of the study developed NEC. During the next 12 months 85 similar infants were initially fed by parenteral nutrition only, and then from age 14-21 days with infant formula. During the second year only 3 (3%) patients developed NEC. There were no other relevant changes in management. Throughout the entire study, the onset of NEC in each infant in whom it occurred was after the start of enteral feeding. We recommend avoiding enteral feeding in VLBW infants during the period that they are particularly vulnerable--namely the first 2 or 3 weeks of life.

Enteral Nutrition↗
PubMed1984

[Enteral feeding--an alternative to parenteral feeding in the treatment of Crohn disease?].

Efficiency of parenteral nutrition and tube feeding were compared in two groups of 25 patients each who suffered from active Crohn's disease. Indication for treatment in these patient groups was an acute phase of the disease with an activity index of higher than 150 and/or body weight below 80% of optimum weight. During the trial no other therapy was given. Target parameters were the Crohn index, body weight, serum albium, hemoglobin, and in a part of the patients the creatinine index. In both groups signs and symptoms of activity were reduced significantly and nutritional status was improved; however, there were now significant differences between groups. From these results the conclusion can be drawn, that enteral nutrition is essentially equally effective as parenteral nutrition in treatment of the acute phase of Crohn's disease. For this reason only patients where there is an absolute contraindication against tube feeding should be supplied with parenteral nutrition.

Adolescent↗
PubMed1987

[Postoperative low-calorie parenteral feeding].

In parenteral nutrition a distinction can be made between hypocaloric, normocaloric, and hypercaloric forms, depending on the amount of energy supply. Hypocaloric parenteral nutrition has been specifically adjusted to the conditions of postoperative metabolism. Doses between 1.2 g and 1.5 g/kg body weight/d of amino acids are the most important components of peripheral venous nutrition. The economy of amino acid utilisation, primarily by patients not adapted to fasting or to ketone body utilisation, can be improved by a low dosage of 2.5 g of carbohydrates to 1 g of amino acids. Polyols were found to be decisively superior to glucose as energy carriers by taking into much closer consideration the mechanisms of autoregulation in postoperative metabolism and by favouring synthesis of intrahepatic functional proteins to peripheral synthesis. Hypocaloric peripheral venous parenteral nutrition has proved to be effective therapeutic concept by which to bridge the early postoperative phase in elective surgery.

Amino Acids↗
PubMed1994

[Clinical importance of hypocaloric parenteral feeding].

Hypocaloric parenteral nutrition (HPN) is mainly and frequently used in surgical medicine since it allows a reliable and standardized supply of nutrients. Ready-mix solutions which are suitable for peripheral venous nutrition generally contain about 50 g carbohydrates (glucose and/or xylitol), 25 g amino acids and electrolytes per liter. The osmolarity of the solutions averages between 600 and 800 mosmol/l. HPN has two distinct advantages: firstly the minimal effects on carbohydrate metabolism and secondly the good improvement in nitrogen balance. If 2 g/kg and day glucose are administered, even postoperatively, the mean blood sugar levels are only just above the normal range and an amino acid dosage of 1 g/kg and day, compared with liquid substitution alone or the administration of small amounts of carbohydrates, leads to an approximately 60% improvement in postoperative N-balance. Experience gained with HPN in surgical medicine to date permits the following recommendation: 1. HPN should not be used after small and moderate interventions with short nutritional abstinence; it is not necessary to administer nutrients in such cases. 2. HPN may be used after moderate to serious surgical interventions; e.g. after gastrointestinal resections in the case of elective surgery on patients with a normal nutritional status. However, studies have yet to prove the clinical efficacy of HPN, e.g. as evidenced by shorter hospitalization or a reduced perioperative morbidity or mortality, although this reservation equally applies to the routinely administered complete parenteral or enteral nutrition.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Glucose↗
PubMed1984

[Ambulatory tube feeding. An alternative to parenteral feeding].

Nowadays, enteral tube feeding is an alternative to parenteral nutrition in hospitalized patients. Special tubes and differentiated diets enable a high quality, enteral nutrition, which can be well applied for a number of indications without complications. This tube feeding can also be managed in ambulatory patients with benign or malignant diseases. The education, training and surveillance of these patients is a necessary requirement. Mobility and living habits of the patients are hardly disturbed at all by this regimen. Deficiencies due to the exclusive application of a chemically defined diet need not to be feared.

Ambulatory Care↗
PubMed2003

Maintaining mucosal immunity during parenteral feeding with surrogates to enteral nutrition.

Pneumonia and intra-abdominal abscesses are significantly lower in trauma patients receiving enteral feeding compared with those receiving parenteral feeding. Extensive experimental evidence suggests that this is related to maintenance of the mucosal-associated lymphoid tissue, which provides immunologic protection for both the gastrointestinal and respiratory tracts against microbial flora and infectious pathogens. This system is exquisitely sensitive to the route and type of nutrition delivery that affects its functional effectiveness. Although parenteral nutrition decreases the effectiveness of this extraintestinal mucosal immunity, specialty nutrients like glutamine and neuropeptides such as gastrin-releasing peptide and cholecystokinin are capable of preventing some of the immune defects associated with parenteral nutrition. This review examines the mechanisms associated with the mucosal immunity and role of both glutamine and neuropeptides in normalizing defects induced by parenteral feeding. Based upon evolving data, specific nutrients and products of the enteric nervous system show promise as adjuncts to parenteral feeding that are capable of maintaining immune function in patients unable to be fed via the gastrointestinal tract.

Journal Article↗
PubMed1978

[Aimed substitution of zinc, copper, magnesium and inorganic phosphates during postoperative parenteral feeding].

In 20 patients, the serum level and urinary output of zinc, magnesium, copper, calcium and anorganic phosphate were examined during postoperative parenteral feeding. The parenteral feeding was standardized. In addition, the above mentioned bioelements were systematically substituted. Effects of this substitution therapy on serum level and urinary output are discussed.

Copper↗
PubMed1979

[Parenteral feeding in pediatric surgery].

Complete, parenteral feeding by continuous drip infusion into large veins over long periods has a solid, therapeutic place in children's surgery. It embraces complete filling of the need for water, salts, glucose, amino acids, triglycerides, essential fatty acids, vitamins and trace elements. Bearing in mind certain basic principles, it can achieve a positive nitrogen balance and so anabolism even in the newborn and nursing infant, in spite of the high demand for calories and nitrogen.

Amino Acids↗
PubMed1979

[Nutritional requirements and parenteral feeding].

1. The nutritional needs of man are governed by the law of the minimum (structural and protective substances) and the isodynamic rule (exchangeability of various energy carriers) There is a tendency to abandon the traditional concept of requirement as an absolute value (g or mg/day) and replace it by 3 graded parameters (minimal - lowest acceptable - desirable supply). Today nutrient density is of utmost importance in the planning and evaluation of food formulas, i.e. the content per 1000 kcal or per MJ = mega-Joule. 2. The metabolism of nutrients proceeds (simplified) in 3 phases: a) digestion (comminution); b) coordination and conversion in intermediary metabolism; c) direct use in synthetic or oxidation processes. This creates problems of balance, of co-ordination and regulation. In the phases b and c the same conformities apply for oral and parenteral feeding. 3. Particular features of parenteral feeding: Exclusion of intestinal flora, limited capacity of uptake by the circulation and, especially, the lowered capacity of biochemical regulatory mechanisms (homeostasis) in patients requiring parenteral feeding necessitate optimal coordination of supply and effective needs. Attempts to comply are made by continuous infusions, diversification of the substrate supply and optimisation of the different components. In principle, priority is given to those nutritional factors which promote anabolism (tissue formation) and counteract catabolism (tissue breakdown). 4. Example: protein needs. --Recapitulation of quantitative and qualitative requirements regarding protein and amino acid supply. --Discussion of the different recommendations and guidelines. --Discussion of the criteria for evaluation and the composition of an optimal amino acid mixture (nitrogen balance and growth as criteria). 5. Conclusions for parenteral feeding. The supply of amino acids should be on the generous side because there is an increased requirement in the "acute phase" and in convalescence. The amino acid composition should correspond to the pattern of a high quality food protein. The E/T ratio (essential AS versus total AS supply) is an indicator. The value proposed as a guideline is E/T approximately 3. However, an exaggerated amino acid cosmetic is not recommended. 6. Diagnostic problems. In the interest of optimal results of treatment, foremost attention should be given to the detection of latent deficiency states and the improvement of nutrition at large. The list of indicators given in the figures should be consulted whenever there is evidence of undersupply. The so-called "hospital malnutrition", as described in recent studies, should obviously not occur.

Amino Acids↗
PubMed1976

[Problems of long-term parenteral feeding in childhood (author's transl)].

Long-term parenteral feeding in childhood must be adapted to the requirements of the young organism. The caloric requirements are mainly provided by glucose and fat emulsions; additional calories can be supplied by xylite and, with some reservations, by fructose. For neonates and young infants the combination and quantity of amino-acids is of particular importance: histidine, arginine, proline and tyrosine are essential amino-acids; glycine, glutamic acid, aspartic acid and cystine should form part of the unspecific sources of nitrogen. Addition of trace elements and vitamins is obligatory in long-term parenteral feeding. Complications may arise at the site of the catheter (sepsis, clotting). Late damage due to intravenous feeding is known to occurs; but a more detailed knowledge needs long-term investigations.

Amino Acids↗
PubMed1996

[Use of parenteral feeding in the multimodality treatment of Crohn's disease and nonspecific ulcerative colitis].

The paper reviews publication on the use of complete parenteral feeding in the multimodality treatment of inflammatory bowel disease. Complete parenteral feeding was performed in patients with skeletization and physical retardation, in severe diseases, in inefficiency or intolerance of conventional therapy with sulfanilamides and steroids, in those who had intestinal fistulas, as well in the preparation of patients for surgical treatment. The use of complete parenteral feeding, under the above circumstances allow one to achieve persistent remission, spontaneous healing of intestinal fistulas, elimination of abnormal metabolism, nutrition, constitution, water-electrolyte balance, to reduce a surgical risk and the incidence of postoperative complications and the length of patients' hospital stay.

Colitis, Ulcerative↗