摘要:

To evaluate the usefulness of nephelometry in predicting hyperlipidemia in neonates receiving intravenous fat (IVF), 23 infants in our neonatal intensive care nursery had simultaneous measurements of the serum IVF level (as determined by nephelometry), triglyceride, cholesterol, and free fatty acid/albumin molar ratio. There was a positive correlation between the serum IVF level and triglycerides, but the IVF level did not reliably predict elevated triglycerides, cholesterol, or free fatty acid‐albumin molar ratio. Thus, neonates receiving IVF emulsions cannot be monitored by nephelometry alone. Adequate monitoring requires measurement of specific lipid fractions.

ISSN:0148-6071    

DOI:10.1177/014860718300700155

出版商:SAGE Publications    

年代:1983

数据来源: WILEY

摘要:

Hemoglobin A1Cor glycosylated hemoglobin has been described as being effective in monitoring long‐term glucose control in diabetics. The usefulness of HbA1Cin reflecting glucose homeostasis during chronic hypertonic dextrose infusions in 6 patients receiving cyclic home TPN was studied at monthly intervals. Grouped data for the 34 values representing study periods of 5 to 10 months averaged 7.5 ± 0.2% (Mean ± SEM) indicating that HbA1Clevels were not elevated above normal (4–8%) in these patients while receiving a dextrose based diet. Final values of HbA1C(7.3 ± 0.4%, mean ± SEM) although lower than early values (8.7 ± 0.6%, mean ± SEM) were not significantly different(p>0.05, Student's paired t‐test). The change in HbA1Cthat occurred in these patients probably reflects the response to an altered glucose load infused by the patient.HbA1Cis a convenient and apparently accurate method of evaluating chronic glucose tolerance in patients receiving home TPN and may be used as an alternate method for monitoring glucose tolerance on an outpatient basis.

ISSN:0148-6071    

DOI:10.1177/014860718300700159

出版商:SAGE Publications    

年代:1983

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718300700162

出版商:SAGE Publications    

年代:1983

数据来源: WILEY

ISSN:0148-6071    

DOI:10.1177/014860718300700114

出版商:SAGE Publications    

年代:1983

数据来源: WILEY

摘要:

The incidence of clinical zinc (Zn) deficiency was rare when solutions used for total parenteral nutrition (TPN) contained amino acids derived from hydrolyzed casein or fibrin, inasmuch as the Zn content of these solutions was high. Between 1978 and 1979 at The University of Iowa Hospitals, the incidence of clinical Zn deficiency increased significantly and was noted in eight patients (3%). During this time, the solution used for TPN contained crystalline amino acids and contained lower levels of Zn. The incidence of clinical Zn deficiency apparently decreased in 1980 and 1981, when the TPN solutions were supplemented with Zn intermittently. Only three patients (1%) developed clinical Zn deficiency. The clinical course of these three patients is reported. All three were in a poor nutritional state and had diseases of the gastrointestinal tract or of the pancreas which are known to be associated with decreased absorption and/or excessive loss of Zn from the body, The signs and symptoms of Zn deficiency developed at a time when the nutritional status of the patients was improving. Zinc serum levels were low (15–40 micrograms per deciliter); but none of the three patients had essential fatty acid deficiency. Treatment with intravenous ZnCl2or oral ZnSO4caused a rapid and dramatic improvement in the signs and symptoms. Skin lesions disappeared within 8 days after initiation of therapy. It is suggested that in similar patients Zn supplementation should be on a daily basis. Urine, stool, and serum Zn levels should be monitored closely, especially when the nutritional status of the patient is improving.

ISSN:0148-6071    

DOI:10.1177/014860718300700172

出版商:SAGE Publications    

年代:1983

数据来源: WILEY

摘要:

Percutaneous insertion of fine silicone elastomer catheters (0.6 millimeters outside diameter) have been used for central parenteral nutrition of very low birth weight and other high risk infants. Because peripheral venous access can be limited in the newborn, we report the previously undescribed surgical cannulation of the superficial arm veins with this catheter, and compare our experience with this technique and the percutaneous method in neonates. A central catheter position was attained in 88% of surgical (38 of 43) and 74% of percutaneous (17 of 23) cannulations. The two groups did not differ in birth weight or gestational age. The mean duration of catheterization was similar in the two groups (combined X = 21.8 ± 2.3 days SEM). There was no difference in weight gain (combined X = 16.9 ± 1.0 grams SEM per day) or head growth (combined X = 1.1 ± 0.1 millimeters per day) between the groups and these rates approximated known fetal growth rates for our mean gestational age. Disseminated candidiasis, in a 770‐gram infant with thymic hypoplasia, caused the only systemic infection and death among our 49 patients. The most commonly encountered problem was catheter occlusion secondary to a blood clot at the tip of these fine catheters (8 of 55). No thromboembolic events were recognized, and minor complications were not different with the two techniques. Surgical cannulation of the superficial arm veins offers a safe alternative to percutaneous central silicone elastomer catheter placement if superficial venous access is not available. Both methods provided early, adequate parenteral nutrition without excessive fluid intake in our high‐risk infants, and undoubtedly contributed to a favorable neonatal outcome.

ISSN:0148-6071    

DOI:10.1177/014860718300700175

出版商:SAGE Publications    

年代:1983

数据来源: WILEY