摘要:

Elemental balances, and skeletal muscle membrane potential (Em) and biopsy were utilized to evaluate electrolyte homeostasis and body composition in 11 healthy adult volunteers after 10 days of starvation. This controlled, acute malnutrition was followed by refeeding for 10 days with two different, commonly used, total parenteral nutrition (TPN) solutions. Six subjects were refed with crystalline amino acids and dextrose (dextrose group), while five subjects received amino acids, dextrose, and lipid (lipid group). During starvation, negative balances for potassium, phosphorous, magnesium, and nitrogen were observed in both groups. When compared to starvation, total parenteral nutrition produced statistically significant (p<0.05) equilibrium or positive electrolyte and nitrogen balances for both, the dextrose and lipid groups. During TPN, there was a significantly (p<0.001) positive chloride balance in the lipid group when compared to the dextrose group. At the conclusion of the 10‐day period of TPN, there was a decrease (p<0.05) in skeletal muscle Em. This change, in concert with the electrolyte balance data obtained during parenteral repletion, lead us to postulate that restoration of lean tissue protein and cellular function does not occur at a rate which might be inferred from the positive nitrogen balance observed in this model. A persistent defect in cellular function which was evident after starvation, suggests that a brief period of TPN is insufficient to restore skeletal muscle integrity. (Journal of Parenteral and Enteral Nutrition12:109–115, 1988)

ISSN:0148-6071    

DOI:10.1177/0148607188012002109

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Medium chain triglycerides (MCT) are supposed to be advantageous on account of rapid energy supply in parental nutrition. However, data on the elimination rate of MCT‐containing emulsions during an intravenous fat‐tolerance test (IVFTT) are scarce. We performed this test (0.1 g lipid/kg body weight) in 18 young healthy volunteers (nine females and nine males) using Lipofundin MCT 10% (50% MCT; egg phospholipids as emulsifier). Our results indicate that both elimination and metabolization of the emulsion are fast: a prompt decrease of light‐scattering index and of triglyceride concentrations in serum, an immediate appearance of post‐load fatty acids and of β‐hydroxybutyrate were observed. This was in good agreement with the findings obtained during 6‐hr infusions in the same probands.Fractional elimination rates k2obtained from light‐scattering indices are 7.29 ± 2.73%/min in males and 11.59 ± 3.38%/ min in females, indicating a higher removal capacity in women. In the same subjects, the corresponding k2 values for Lipofundin S 10% (containing only long chain triglycerides) were higher, reflecting an elimination rate that is faster due to the use of soya bean phospholipids as emulsifier. In comparison, k2 values based on the course of the triglyceride concentrations are generally lower. (Journal of Parenteral and Enteral Nutrition12:116–120, 1988)

ISSN:0148-6071    

DOI:10.1177/0148607188012002116

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

The ability of soybean oil lipid emulsions to affect essential fatty acid deficiency (EFAD) and plasma fatty acid distribution was studied in neonatal pigs. The test animals were maintained on a fat‐free diet prior to administration of lipid emulsion. Plasma and red blood cell (RBC) membrane levels of essential [linoleic (C‐18:2ω6) and arachidonic (C‐20:4ω6)] and nonessential [palmitic (C‐16, palmitoleic (C‐16:1ω7), stearic (C‐18), and oleic (C‐18:1ω9)]fatty acids and the triene:tetraene ratio [5.8,11‐eicosatrienoic acid (C‐20:3ω9):arachidonic acid (C‐20:4ω6)] were monitored to ascertain the establishment of EFAD and its correction. Nonessential fatty acids were studied, as these components of lipid therapy have received little attention. Results indicate that soybean oil emulsions are effective in reversing fatty acid profiles found in EFAD, and both essential and nonessential fatty acids are under strict metabolic control. (Journal of Parenteral and Enteral Nutrition12:121–126, 1988)

ISSN:0148-6071    

DOI:10.1177/0148607188012002121

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

A prospective study was undertaken to compare the risks of a multiple‐lumen catheter to bilateral subclavian catheters in patients receiving total parenteral nutrition (TPN). All patients had one preexisting subclavian catheter. Patients were randomized into two groups: one group received a double‐lumen catheter via a guidewire change of the preexisting single‐lumen subclavian catheter. In the second group, a second single‐lumen subclavian catheter was inserted and the preexisting single‐lumen catheter was changed over a guidewire. Patients were followed by the Nutrition Support Service and were managed identically with regard to solutions given, catheter care, dressing changes, monitoring of mechanical complications, and evaluation of fever. Total infection rates in both groups were identical (22.7%). The difference in mechanical complication rates in the double‐lumen catheter group (9%) and the group with bilateral single‐lumen catheters (22.7%) was not significant by Fischer's exact test. The multiple‐lumen catheter is superior in convenience and as safe as bilateral single‐lumen catheters. (Journal of Parenteral and Enteral Nutrition12:127–129, 1982)

ISSN:0148-6071    

DOI:10.1177/0148607188012002127

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

The purpose of this study was to determine the degree of intercorrelation among dietitian, physician, and team nutrition support functions. Eight hundred and eighty dietitians and physicians were asked to respond to a questionnaire describing nutrition support functions as reported in the literature and validated by a panel of nutrition support physicians and dietitians. Two hundred and fifty‐four completed questionnaires were included in the study, 84 from physicians and 170 from dietitians. Intercorrelations among function statements were subjected to factor analysis. The magnitude and consistency of factor loadings suggest that nutrition support is not perceived as independent components, but as a comprehensive pattern or structure. However, there was one important difference in perception. The sample tended to have an “enteral” orientation to the dietitian role and a “parenteral” orientation to the physician and team roles. The data support the contention that all members of nutrition support teams need a common core of knowledge and a set of highly developed process skills which can best be attained through an integrated, rather than segmented, approach to team training. (Journal of Parenteral and Enteral Nutrition12:130–134, 1988)

ISSN:0148-6071    

DOI:10.1177/0148607188012002130

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

A widely held assumption is that postpyloric intubations occur more often with weighted than with unweighted nasally inserted feeding tubes. This randomized, prospective study compared the frequency of duodenal intubations using weighted and unweighted nasoenteric feeding tubes. One hundred sixteen patients had either weighted (61 patients) or unweighted (55 patients) 10F silicone elastomer feeding tubes inserted nasally 85 cm. Tubes were placed with wire stylets. Tube positions were verified radiographically within 4 hr after insertions. Radiographs were repeated daily for 3 days or until duodenal intubation occurred. Successful duodenal intubations were achieved in 35 patients (57%) with weighted feeding tubes and in 37 patients (67%) with unweighted feeding tubes. This difference was not significant. Weighted nasoenteric feeding tubes offer no advantage over unweighted tubes in achieving duodenal intubations. (Journal of Parenteral and Enteral Nutrition12:135–137, 1988)

ISSN:0148-6071    

DOI:10.1177/0148607188012002135

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

The utilization of delayed hypersensitivity response (DHR) for the identification of high‐risk patients with regard to postoperative septic complications is still discussed. The aim of this study was to clarify how much DHR may improve the prognostic capacity of nutritional assessment (NA). Nutritional and immunological evaluations were performed at admission on 405 patients undergoing elective general surgical procedures. Subjects with serum albumin ≤3.0 g/ dl or total iron‐binding capacity ≤220 μg/dl or weight loss ≥10% with respect to usual body weight were classified as malnourished. DHR was assessed by performing skin tests with four recall antigens: PPD, candida, trichophyton, sk‐sd. The incidence of postoperative complications resulted higher among the 187 malnourished patients (31.0%) than in the 218 well‐nourished ones (14.2%) (p<0.001), and among the 213 anergic patients (29.6%) than in the 192 normal responders (13.5%) (p<0.001). To determine how much skin tests may improve the prognostic ability of NA, the relationship between DHR and postoperative complications was also studied in the malnourished and in the well‐nourished patients, separately. In the malnourished group, the patients with an impairment of DHR had a higher incidence of postoperative infections than normal responders (p<0.05). In the well‐nourished group, no significant differences were found between anergic patients and normal responders. In our study, DHR slightly improved the prognostic capacity of NA. Therefore, the first approach to identify the high‐risk patients seems to be the unexpensive, quick, and available determination of nutritional status. (Journal of Parenteral and Enteral Nutrition12:138–142, 1988)

ISSN:0148-6071    

DOI:10.1177/0148607188012002138

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Serum carnitine levels have been measured in 178 samples from 75 normal volunteers. We report a wide range of values (10–70 μmol/liter and 8–74 μmol/liter for free and acetylated carnitine, respectively) and a distinct difference between the ranges for males and females (p<0.001). There is also substantial, seemingly random fluctuation in any one individual's levels, when measured serially over several weeks. (Journal of Parenteral and Enteral Nutrition12: 143–146, 1988)

ISSN:0148-6071    

DOI:10.1177/0148607188012002143

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Most human cancers arise in epithelial tissues, which are critically dependent on vitamin A for normal differentiation and proliferation. Dietary carotenoids consist of individual retinoids—pro‐vitamin A precursors and non‐pro‐vitamin A precursors—displaying different biological activity. Although epidemiological data suggest that low serum vitamin A levels were associated with an increased risk of cancer, it is not known whether one specific or all vitamin A carotenoids are involved.To assess whether the plasma carotenoids are related to the nutritional or cancer‐bearing state, a study was conducted to measure total and individual carotenoids in four groups: cancer‐bearing, malnourished; cancer‐bearing, well‐nourished; non‐cancer, malnourished; and well‐nourished volunteers of comparable age and sex.There was no difference in total carotenoids and pro‐vitamin A precursors between the well—nourished—both normal volunteers and cancer patients. Malnourished cancer and non‐cancer patients had significantly (p<0.05) lower value of both. Most of the circulating carotenoids in all groups were the non‐pro‐vitamin A precursors. Both malnourished cancer and non‐cancer patients had lower values than well‐nourished (p<0.05). Differences were related to nutritional state, rather than presence of cancer. (Journal of Parenteral and Enteral Nutrition12:147–151, 1988)

ISSN:0148-6071    

DOI:10.1177/0148607188012002147

出版商:SAGE Publications    

年代:1988

数据来源: WILEY

摘要:

Weanling rats were made vitamin E deficient over a 10‐week course. Vitamin E was then provided at 4 IU/ kg/day as a continuous infusion of the α‐tocopherol in Berocca PN. Tissue samples of heart, lung, liver, and perinephric fat and plasma were analyzed for vitamin E levels at 24 and 72 hr.Compared to experimental controls that received a rat chow containing 372 IU/g mixed tocopherol, normal levels were achieved in the test group within 24 hr in plasma and liver. Lung and heart muscle levels were within the normal range by 24–72 hr, although significantly below the control level; fat levels did not normalize. Continuous infusion of vitamin E as tocopherol in a multivitamin preparation results in normal tissue levels in lung and liver in a fashion similar to that achieved by previously described methods of single bolus intravenous infusion or repeated subcutaneous injection. (Journal of Parenteral and Enteral Nutrition12:152–154, 1988)

ISSN:0148-6071    

DOI:10.1177/0148607188012002152

出版商:SAGE Publications    

年代:1988

数据来源: WILEY