Advances in clinical nutrition : proceedings of the 2nd international symposium, held in Bermuda, 16-20th May 1982

The advent of any new and effective therapy is soon followed by large numbers of publications in which the indications and benefits are explored critically. It is not unexpected, therefore, that within five years of the first Bermuda Symposium on advances in parenteral nutrition that a second Symposium was considered appropriate to review progress and explore new areas of investigation, as well as enlarging the scope of the meeting to include enteral nutrition. The rate of progress can be judged by the number of subjects which were not discussed at the first Symposium. For example, home parenteral nutrition, computer assisted assessment and prescribing, Studies of body protein synthesis and breakdown and the role of branched-chain amino acids are all new subjects for this Symposium which were not covered at all in the first meeting. Much progress has also been made to our understanding of the biochemi­ cal complications of parenteral nutrition and the problems related to long term access to the circulation. Nutritional care has become safer and more effective. There is an increasing awareness of the difficulties in making a true nutritional assessment in selecting patients for total parenteral nutrition and more attention has also been focussed on different approaches to enteral support in the management of undernourished patients. There is also continuing debate on the cost effectiveness of this expensive method of treatment and critics look in vain for evidence of efficacy based on controlled trials in specific groups of patients. Front Matter....Pages i-xxxii Front Matter....Pages 1-1 Branched-chain amino acids: metabolic roles and clinical applications....Pages 3-23 Intracellular and plasma branched-chain amino acid interrelationships....Pages 25-36 Branched-chain amino acid supplementation in the injured rat model....Pages 37-49 Review of branched-chain amino acid supplementation in trauma....Pages 51-64 The importance of study design to the demonstration of efficacy with branched-chain amino acid enriched solutions....Pages 65-75 Branched-chain amino acids in surgically stressed patients....Pages 77-82 Selective nutritional support for hepatic regeneration: experimental and clinical experiences with branched-chain amino acids....Pages 83-101 The effect of branched-chain amino acids on body protein breakdown and synthesis in patients with chronic liver disease....Pages 103-109 Front Matter....Pages 111-111 Nutritional therapy for patients with acute renal failure....Pages 113-122 Can low protein diet retard the progression of chronic renal failure?....Pages 123-129 Experience with prolonged intradialysis hyperalimentation in catabolic chronic dialysis patients....Pages 131-146 Front Matter....Pages 147-147 Enteral feeding in liver failure....Pages 149-161 Nutritional support in the thermally injured patient....Pages 163-170 Breast milk in neonatal care....Pages 171-176 Front Matter....Pages 177-177 Intravenous fat emulsions: a neonatologist’s point of view....Pages 179-188 Clinical applications of 20% fat emulsions....Pages 189-192 Changes in binding of bilirubin due to intravenous lipid nutrition....Pages 193-205 Clinical experience with fat-containing TPN solutions....Pages 207-212 The stability of fat emulsions for intravenous administration....Pages 213-239 The stability and comparative clearance of TPN mixtures with lipid....Pages 241-260 Front Matter....Pages 177-177 Problems and prospects in lipid metabolism during parenteral nutrition....Pages 261-271 Front Matter....Pages 273-273 Alterations in fuel metabolism in stress....Pages 275-281 The carbohydrate content of parenteral nutrition....Pages 283-291 Fat utilization in critically ill patients....Pages 293-301 Liver malfunction associated with parenteral nutrition....Pages 303-312 Front Matter....Pages 313-313 Role of carnitine supplementation in clinical nutrition....Pages 315-324 Experience with alternative fuels....Pages 325-337 Topical nutrition — a preliminary report....Pages 339-349 Nutritional and immunological parameters for identification of the high risk patient....Pages 351-365 Front Matter....Pages 367-367 Intestinal failure and its treatment by home parenteral nutrition....Pages 369-381 Implementation of a home nutritional support programme....Pages 383-388 Techniques of longterm venous access....Pages 389-399 Home parenteral nutrition....Pages 401-410 Quality of life for the home-care patient....Pages 411-417 Experience with ambulatory total parenteral nutrition in Crohn’s disease....Pages 419-431 Preliminary report on collaborative study for home parenteral nutrition patients....Pages 433-448 Front Matter....Pages 449-449 Future directions....Pages 451-456 Thoughts for the future of clinical nutrition....Pages 457-463 Concluding remarks to the symposium on clinical nutrition....Pages 465-469 Back Matter....Pages 471-483