摘要:

The use of growth hormone in clinical nutritional support has received considerable attention over the past decade. The most encouraging results have been improved nitrogen retention and protein synthesis in the presence of hypocaloric nutritional support. Adverse effects, however, can limit the clinical usefulness of this technology. In the following case study, an obese 71‐year‐old man with a history of chronic obstructive pulmonary disease remained ventilator dependent 2 months following anterior cervical fusion and had severe depletion of visceral proteins despite nitrogen equilibrium. He was treated with 10 mg of recombinant human growth hormone (Genentech) subcutaneously every other day while also receiving nutritional support. We hypothesized that growth hormone administration could promote both protein synthesis and the development of muscle mass, particularly in the respiratory muscles, without increasing nutrient intake and, therefore, without increasingCO2production. The patient, however, developed two potentially life‐threatening adverse effects: hyperglycemia and fluid retention. The severity of these adverse effects led to discontinuation of this mode of therapy.

ISSN:0884-5336    

DOI:10.1177/011542659200700127

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

Running enteral nutrient solution (ENS) bacterial contamination logs that were collected over a 6‐year time frame are presented. At hospital A, reconstituted ENS were prepared by the pharmacy department in bulk and were frozen in the final container. These solutions were cultured and counted after 12 hours of storage at room temperature to stimulate this institution's hang time. Major reductions in ENS bacterial counts occurred after improvements in sanitation, a reduction in solution hang time, the conversion to the use of sterile water for dilution and reconstitution of ENS, and most dramatically, after the incorporation of a preservative (potassium sorbate) to reconstituted ENS. At hospital B, ENS usage consisted of canned feedings that were prepared by nursing personnel and were transferred to the feeding container at the bedside. Reductions in final counts of contamination of ENS occurred after procedural changes, which included container changes every 24 hours, use of sterile water for dilution, cleansing of can lids with alcohol swabs before use, rinsing and air drying of intermittent feeding containers between feedings, and limiting feeding container fills to 4‐hour hang time quantities. At both institutions, the value of an ongoing three‐class enteral quality control program with a defined acceptance/ rejection criteria was demonstrated in that ENS contamination was reduced to acceptable levels comparable with federal standards for milk and dairy products.

ISSN:0884-5336    

DOI:10.1177/011542659200700131

出版商:Sage Publications    

年代:1992

数据来源: WILEY

摘要:

Animal models are used extensively in nutritional research. Studies with animal models may not provide a discussion of the applicability of the model to humans, and seldom do such studies discuss the limitations of the model. This article presents information that is targeted toward the nutrition support practitioner about the use of animal models in nutritional research. The rationale for using animal models and the applicability to humans, the limitations of applicability, and the unique opportunities related to animal models is presented.

ISSN:0884-5336    

DOI:10.1177/011542659200700137

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700110

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700111

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700114

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/088453369200700115

出版商:Sage Publications    

年代:1992

数据来源: WILEY

ISSN:0884-5336    

DOI:10.1177/011542659200700144

出版商:Sage Publications    

年代:1992

数据来源: WILEY