Commentary on Parenteral Nutrition

Nutritional requirements of young infants, both premature and full-term, can be met better by recognizing the absorptive and digestive limitations present. When gastrointestinal disease is superimposed on an immature digestive system, special support frequently is needed to maintain adequate growth. This support can be offered as parenteral nutrition or with specialized enteral feeding techniques and formulations. Because parenteral solutions are formulated to provide complete nutritional support, they may be used for short as well as extended periods of time. Recommendations for use include: 1. Careful catheter placement and confirmation of position by roentgenogram; strict adherence to aseptic techniques and established guidelines of catheter care; and laboratory and clinical monitoring of patients for intolerance. 2. Protein, in the form of crystalline amino acids, should be provided at a rate of 2 to 3 g/kg/d. The concentration of carbohydrate, as glucose (dextrose), should be advanced in a methodical manner to ensure tolerance.

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Nutrition as an important component of treatment and rehabilitation in cancer patients

HEALTH OF WOMAN ◽

10.15574/hw.2020.149.15 ◽

2020 ◽

pp. 15-22

Author(s):

T.F. Tatarchuk ◽

◽

E.G. Manzhalii ◽

D.V. Pominchuk ◽

T.S. Shevchuk ◽

...

Keyword(s):

Cancer Patients ◽

High Frequency ◽

Nutritional Support ◽

Digestive System ◽

Multidisciplinary Approach ◽

Dietary Factors ◽

Protective Activity ◽

Macro And Micronutrients ◽

Diet And Lifestyle ◽

Cachexia Syndrome

The article deals with the importance of nutritional support for cancer patients. The high frequency of malnutrition and impaired absorption of macro and micronutrients in cancer patients and, which, at its maximum, is anorexia-cachexia syndrome, is the direct cause of the patient’s death. The progression of the tumor process is always accompanied by a violation of nutritional status, which is manifested in changes in weight, weakness, decreased physical activity, and disorders of the digestive system. It is estimated that about half of cancer-related deaths can be prevented, many of which are due to diet and lifestyle. Dietary factors can be involved in the initiation of tumor growth (carcinogens), promote growth, or have protective activity against the development of cancer. Therefore, nutritional support is one of the important components of a multidisciplinary approach in the treatment of cancer. Based on the analysis of the literature, the main tasks of nutritional support, indications, methods and criteria for the effectiveness of therapeutic nutrition are determined for the practitioner, a brief overview of the diets that are used by cancer patients is presented, and a list of anticarcinogenic products is compiled. Key words: anticarcinogenic products, diet, nutritional support, cancer patient, cancer prevention, nutrition.

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Approaches to common conditions of the gastrointestinal tract in pet hamsters

Companion Animal ◽

10.12968/coan.2020.0085 ◽

2021 ◽

Vol 26 (3) ◽

pp. 20-26

Author(s):

Vicki Baldrey

Keyword(s):

Nutritional Support ◽

Gastrointestinal Disease ◽

Parasitic Infection ◽

Positive Contrast ◽

Abdominal Ultrasound ◽

Gastrointestinal Diseases ◽

Indications For Surgery ◽

Pet Trade ◽

Free Environment ◽

The Uk

Hamsters are popular pets in the UK. The Syrian or Golden hamster (Mesocricetus auratus) is the best known species in the pet trade, with a variety of dwarf species also encountered. Gastrointestinal disease occurs frequently, and diarrhoea is a common presenting complaint. This is most often associated with bacterial or parasitic infection, but can also be related to neoplasia or the use of certain antibiotics. Initial stabilisation of the hamster with diarrhoea should include provision of a warm stress-free environment, fluid therapy, nutritional support with an appropriate critical care diet and analgesia. Following a full history and clinical examination, further diagnostic steps include faecal parasitology and microbiology, routine biochemistry and haematology, radiography with or without positive contrast, and abdominal ultrasound. Indications for surgery include evidence of intestinal obstruction or prolapsed intussusception. This article gives an overview of the most common gastrointestinal diseases encountered in hamster species and provides a guide of how to logically approach the investigation and treatment of these cases, achievable in general practice.

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Comparative study between total parenteral nutrition (TPN) and no nutritional support in perioperative bariatric surgery

Clinical Nutrition ◽

10.1016/s0261-5614(03)80069-9 ◽

2003 ◽

Vol 22 ◽

pp. S19

Author(s):

M.J. Martinez ◽

M.A. Martinez ◽

M.J. Morales ◽

P. Parada ◽

I. Otero ◽

...

Keyword(s):

Bariatric Surgery ◽

Parenteral Nutrition ◽

Comparative Study ◽

Total Parenteral Nutrition ◽

Nutritional Support

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Managing children and adolescents on parenteral nutrition: challenges for the nutritional support team

Proceedings of The Nutrition Society ◽

10.1079/pns2006502 ◽

2006 ◽

Vol 65 (3) ◽

pp. 217-221 ◽

Cited By ~ 21

Author(s):

Tracey Johnson ◽

Elaine Sexton

Keyword(s):

Parenteral Nutrition ◽

Children And Adolescents ◽

Nutritional Support ◽

Intestinal Failure ◽

Home Care Services ◽

Cholestatic Liver Disease ◽

Care Services ◽

Child Assessments ◽

The Individual ◽

At Home

Managing infants, children and adolescents, ranging from premature infants to 18-year-old adolescents, on parenteral nutrition (PN) is a challenge. The ability of children to withstand starvation is limited and, unlike adults, children require nutrition for growth. PN in children is often required secondary to a congenital bowel problem rather than because of an acquired condition. Conditions requiring PN include motility disorders, congenital disorders of the intestinal epithelium and short-bowel syndrome (SBS). Intestinal failure may be temporary and children with SBS may be weaned from PN. However, other children require permanent PN. There are no comprehensive guidelines for the nutritional requirements of children and adolescents requiring PN. Practice in individual centres is based on clinical experience rather than clinical trials. Requirements are assessed on an individual basis according to age, nutritional status and clinical condition. These requirements need regular review to ensure that they remain appropriate for the changing age and weight of the child. Assessments of intakes use different methods, e.g. reference tables and predictive equations. Complications of PN include infection, accidental damage to, or removal of, the line and cholestatic liver disease. Home parenteral nutrition (HPN) is associated with fewer line infections and allows continuation of nutritional support in a more normal environment, encouraging normal development and participation in family activities. However, having a child at home on HPN is associated with physical and psychological stresses. A feeling of depression, loneliness and social isolation is common amongst children and their families. Home-care services are essential to supporting children at home and should be tailored to, and sensitive to, the individual needs of each family.

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Preliminary Experience With Intestinal Transplantation in Infants and Children

PEDIATRICS ◽

10.1542/peds.97.4.443 ◽

1996 ◽

Vol 97 (4) ◽

pp. 443-448

Author(s):

Alan N. Langnas ◽

B. W. Shaw ◽

Dean L. Antonson ◽

Stuart S. Kaufman ◽

David R. Mack ◽

...

Keyword(s):

Small Bowel ◽

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Short Bowel Syndrome ◽

Gastrointestinal Disease ◽

Intestinal Transplantation ◽

Infants And Children ◽

Short Bowel ◽

In Infants And Children

Objective. This report discusses the preliminary experience with intestinal transplantation in children at the University of Nebraska Medical Center. Patients. During the past 4 years, 16 intestinal transplants have been performed in infants and children. Thirteen have been combined liver and bowel transplants, and the remainder were isolated intestinal transplants. Nearly half of the patients were younger than 1 year of age at the time of surgery, and the vast majority were younger than 5 years of age. All but one had short bowel syndrome. Results. The 1-year actuarial patient and graft survival rates for recipients of liver and small bowel transplants were 76% and 61%, respectively. Eight of 13 patients who received liver and small bowel transplants remain alive at the time of this writing, with a mean length of follow-up of 263 (range, 7 to 1223) days. Six patients are currently free of total parenteral nutrition. All three patients receiving isolated intestinal transplants are alive and free of parenteral nutrition. The mean length of follow-up is 384 (range, 330 to 450) days. Major complications have included severe infections and rejection. Lymphoproliferative disease, graft-versus-host disease, and chylous ascites have not been major problems. Conclusions. Although intestinal transplantation is in its infancy, these preliminary results suggest combined liver and bowel transplants and isolated intestinal transplantation may be viable options for some patients with intestinal failure caused by short bowel syndrome or other gastrointestinal disease in whom long-term total parenteral nutrition is not an attractive option.

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Complications of nutritional support

Emergencies in Gastroenterology and Hepatology ◽

10.1093/med/9780199231362.003.0011 ◽

2013 ◽

pp. 171-180

Author(s):

Daniel Marks ◽

Marcus Harbord

Keyword(s):

Central Venous Catheter ◽

Enteral Nutrition ◽

Parenteral Nutrition ◽

Right Atrium ◽

Nutritional Support ◽

Venous Catheter ◽

Central Venous ◽

Catheter Tip ◽

Central Catheters

Venous catheter-related problems Other complications of parenteral nutrition Problems with enteral tubes Re-feeding syndrome ● Above all else, ‘if the gut works, use it’. Only consider IV feeding if patients are likely to be without enteral nutrition for 〉5d. ● Central venous catheter feeding (i.e. catheter tip in SVC, IVC, or right atrium) preferred to avoid thrombophlebitis from hyperosmolar feeds. Well-managed central catheters can be left ...

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Principles of nutritional support

Current Surgical Guidelines ◽

10.1093/med/9780198794769.003.0022 ◽

2018 ◽

pp. 199-206

Author(s):

Abdullah Jibawi ◽

Mohamed Baguneid ◽

Arnab Bhowmick

Keyword(s):

Risk Factor ◽

High Risk ◽

Parenteral Nutrition ◽

Clinical Assessment ◽

Nutritional Support ◽

Length Of Hospital Stay ◽

Screening Methods ◽

Hospital Patients ◽

Lower Infection ◽

Malnutrition Universal Screening Tool

Malnutrition is a commonly found risk factor in hospitalized patients. All hospital patients, especially the high-risk ones, should be offered nutritional screening. Methods of screening include MUST (Malnutrition Universal Screening Tool) and the patient should have a thorough clinical assessment and investigations. The patient should meet adequate calorie requirement either by oral or enteral or parenteral nutrition. Malnourished patients receiving nutrition supplements demonstrated lower infection rates and shorter length of hospital stay compared to no supplements.

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