... in parenteralnutrition catheterization Clin Nutr 2001;20:527-534 Allwood MC Microbiological risks in parenteralnutrition compounding Nutrition 1997;13:60-61 Didier ME, Fischer S, Maki DG Total ... in lipid emulsions used in parenteralnutrition Arch Surg 1975;110:1479-1481 Goldmann DA, Martin WT, Worthington JW Growth of bacteria and fungi in totalparenteralnutrition solutions Am J Surg ... microorganisms in total nutrient admixtures Drug Intell Clin Pharm 1987;21:633-638 Gilbert M, Gallagher SC, Eads M, Elmore MF Microbial growth patterns in a totalparenteralnutrition formulation...
... that contain these micronutrients Table 73-4 Usual Daily Electrolyte Additions to ParenteralNutrition Electrolyte Parenteral Usual Intake Equivalent of RDA Sodium 1–2 meq/kg + replacement, but ... acidbase balance Vitamin and trace element requirements are met by the daily provision of a complete parenteral vitamin supplement and trace elements for PN, and with the provision of adequate amounts ... recuperating patient Each g N represents approximately 30 g lean tissue Mineral and Vitamin Requirements Parenteral electrolyte, vitamin, and trace mineral requirements are summarized in Tables 73-4, 73-5,...
... SURGICAL CRITICAL CARE VIVAS P ᭹ ᭹ PARENTERALNUTRITION 172 Once per day: Serum electrolytes Urea and creatinine Twice-weekly check: Albumin and total protein Calcium Magnesium Phosphate ... the serum potassium? 3.5–5.0 mmol/l What is the distribution of potassium in the body? 98% of the total body potassium is intracellular The intracellular concentration is ~150 mmol/l compared to ... assessing arterial oxygen saturation (SaO2) and pulse rate Note that it is not a measure of the total oxygen content of the blood nor the PaO2 It does not assess ventilation, which requires a...
... dramatically enhance survival Although enteral nutrition (EN) can be provided by most health care teams caring for hospitalized patients, safe and effective parenteralnutrition (PN) usually requires specialized ... for Specialized Nutritional Support Indications for Specialized Nutritional Support Although at least 15–20% of patients in acute care hospitals have evidence of significant malnutrition, only ... consequence of inadequate nutritional intake Enteral refers to feeding via a tube placed into the gut to deliver liquid formulas containing all essential nutrients Parenteral refers to the infusion...
... luminal nutrition should be provided, even when PN is required to provide most of the nutritional support The combination of some enteral feeding either by mouth or by enteral tube with parenteral ... rates However, there is little convincing evidence that SNS as caloric supplementation improves nutrition or pulmonary function PCM is also common in the course of cancer and HIV disease, although ... considerable clinical evidence that it improves pregnancy outcomes Risks and Benefits of Specialized Nutrition Support The risks are determined primarily by patient factors such as state of alertness,...
... therapy benefits quality of life Table 73-2 Summary of Outcomes for Patients on Home Parenteral and Enteral Nutrition (HPEN) Therapy Status, yearb % at Rehabi litationc Complic ationsd per Status, ... ied Year Surv Oral d Group s H N PEN onHPE on N ivala Nutr HPEN on ition Rx Ther apy Home ParenteralNutrition Cr ohn's 62 6 0 1 disease Isc hemic 31 7 1 bowel disease M otility 99 1 9 1 disorder ... ronic 20 3 3 adhesive obstructio ns Cy stic 1 6 fibrosis Ca ncer 122 AI DS 80 3 3 3 Home Enteral Nutrition Ne urologic 134 5 9 disorders of swallowi ng Ca ncer 644 a 0 9 Survival rates on therapy...
... stressed patients, often benefit from fluid and sodium restriction to levels of 1000 mL of totalparenteralnutrition (TPN) formula and 5–20 meq of sodium per day In patients with severe chronic...
... separately, parenteral fat should not be provided at rates exceeding 0.11 g/kg body weight per h or about 100 g over 12 h—equivalent to L of 10% parenteral fat and 500 mL of 20% parenteral fat ... calories, while parenteral fat comes in separate containers as 10, 20, and 30% emulsions that can be infused separately or mixed by the pharmacy under controlled conditions as all-in-one or total nutrient ... glucose and amino acids are provided parenterally until the level of resting energy expenditure is reached At this point, adding fat becomes beneficial, since more parenteral glucose stimulates de...
... metals in recommended amounts Note: PN, parenteral nutrition; TPN, totalparenteralnutritionParenteralNutrition Infusion Technique and Patient Monitoring Parenteral feeding through a peripheral ... tolerated peripherally Parenteral fat (20%) can be given to increase the calories delivered The total volume required to provide a marginal protein intake of 60 g and 1680 total kcal is 2.5 L However, ... low-glucose regimens Parenteral feeding via a peripheral vein is generally intended as a supplement to oral feeding and is not optimal for the critically ill Peripheral parenteralnutrition may benefit...
... addition of 6000 U of heparin in the daily parenteral formula in hospitalized patients with temporary catheters reduces the risk of fibrin ... related to permanent catheters A recent U.S Food and Drug Administration mandate to reformulate parenteral multivitamins to include vitamin K at a dose of 150 µg daily may affect the efficacy ... the absence of gastrointestinal losses or renal dysfunction, net fluid retention is likely when total fluid intake exceeds 2000 mL/d Close monitoring of body weight, as well as fluid intake and...
... magnesium malabsorption, malnutrition Critical illness Supplement magnesium Hypophosphatemia Inadequate intake Supplement relative to needs related to phosphorus malnutrition, alcohol use Increased ... function renal replacement therapy if cannot provide g protein per kg for periods Note: PN, parenteralnutrition prolonged ... maintaining sodium free water clearance; can also and chloride balance occur with dehydration and normal total body sodium Hypokalemia Inadequate intake relative to need Excessive Use supplements diuresis,...
... hypotension should precipitate catheter removal in either the temporary or permanent PN setting Enteral Nutrition Tube Placement and Patient Monitoring The types of enteral feeding tubes, methods of insertion,...
... to 30 degrees, using nurse-directed algorithms for formula advancement, combining enteral with parenteral feeding, and using post–ligament of Treitz feeding Tube feeding should not be discontinued...
... den Berghe G: Risks and benefits of nutritional support during critical illness Annu Rev Nutr 26:513, 2006 [PMID: 16848718] Koretz RL et al: Does enteral nutrition affect clinical outcome? A ... in critical illness Proc Nutr Soc 62:545, 2003 [PMID: 14506903] Simpson F, Doig GS: Parenteral vs enteral nutrition in the critically ill patient: A meta-analysis of trials using the intention ... appropriate to persist with tube feeding, despite the diarrhea, even when this necessitates supplemental parenteral fluid support Acknowledgment The authors acknowledge the contributions of Lyn Howard,...
... with totalparenteral nutrition? A single institution's 20-year experience Cancer 2005, 103:863-868 11 Shang E, Weiss C, Post S, Kaehler G: The influence of early supplementation of parenteralnutrition ... http://www.hqlo.com/content/8/1/41 there are some studies showing the benefits of home -parenteral nutrition (HPN) in cancer-associated malnutrition, its use is discussed controversially from both an economical ... Cancer Treatment Group study J Clin Oncol 2002, 20:567-573 Mackenzie ML, Gramlich L: Home parenteralnutrition in advanced cancer: where are we? Appl Physiol Nutr Metab 2008, 33:1-11 Tisdale...
... Su XY, Drover JW: Totalparenteralnutrition in the surgical patient: a metaanalysis Can J Surg 2001, 44:102-111 Heyland DA, MacDonald S, Keefe L, Drover JW: Totalparenteralnutrition in the ... form of nutrition started (days) (3–7) (3–7) 0.21 Duration of parenteralnutrition (days) (6–21) (4–11) 0.0001 Duration of enteral feeding (days) (6–20) (3–10) 0.0001 Indication for totalparenteral ... Perioperative totalparenteralnutrition in surgical patients N Engl J Med 1991, 325:525-532 Gramlich L, Kichian K, Pinilla J, Rodych NJ, Dhaliwal R, Heyland DK: Does enteral nutrition compared to parenteral...
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