Advances in Parenteral Nutrition : Proceedings of an International Symposium Held in Bermuda, 16–19th May, 1977

Parenteral nutrition has been one of the most significant therapeutic advances of the past twenty years. Many patients have survived very serious illness only because of intravenous nutrition for either short or very long periods of time. The indications for parenteral nutrition are simple and can be summarised as the inability to ingest necessary nutrients for a significant time during increased metabolic demands. Many problems in the preparation of energy sources and amino acid solutions have been solved so that the time is opportune to review what has been achieved and discuss recent advances and current thinking in the light of future requirements. The next phase in parenteral nutrition will undoubtedly be the provision of regimens designed for specific situations. The needs of the neonate for example are known to differ from adult requirements. The choice of carbohydrate for intravenous use has been a matter of much of glucose both in biochemical and clinical terms discussion. The supremacy now seems well established. The value of intravenous fat is well documented, but the interchange of fat and carbohydrate as calorie sources and the effects of prolonged infusions of fat merit further investigation. The evidence that isotonic amino acids are utilized effectively when given alone due to the availability of endogenous energy sources has led to a greater understanding of the metabolic changes and demands associated with injury and sepsis. Front Matter....Pages i-xvi Front Matter....Pages 1-1 Metabolic foundations of intravenous nutrition....Pages 3-20 Front Matter....Pages 21-21 Some general considerations concerning the use of carbohydrates in parenteral nutrition....Pages 23-28 Metabolic pathways for carbohydrates in parenteral nutrition....Pages 29-44 Short-term parenteral nutrition with and without fructose....Pages 45-60 Evaluation of non-glucose carbohydrates in parenteral nutrition....Pages 61-74 Front Matter....Pages 83-83 Intracellular amino acids and energy metabolism in catabolic patients with regard to muscle tissue....Pages 85-106 Biological limiting factors to parenteral amino acid feeding in man....Pages 107-118 Isotonic crystalline amino acids for protein sparing....Pages 119-140 The protein-sparing effect of isotonic amino acids: metabolic considerations....Pages 141-161 Front Matter....Pages 163-163 The use of fat emulsions in parenteral nutrition....Pages 165-178 Lipid metabolism in stress....Pages 179-194 Role of lipid as a source of nonprotein calories....Pages 195-209 Effect of long-term administration of fat emulsion on lipid deposition in the reticuloendothelial system in man....Pages 211-218 Toxicity of lipids....Pages 219-229 Front Matter....Pages 231-231 Trace element formulations in intravenous feeding....Pages 233-240 Zinc and other trace elements....Pages 241-261 Front Matter....Pages 265-265 Aspects of intravenous feeding in childhood....Pages 267-280 Study of the use of total parenteral nutrition in neonates suffering from necrotizing enterocolitis....Pages 281-292 Use of Travasol in paediatric patients....Pages 293-300 Abnormalities of amino acid metabolism in the newborn....Pages 301-316 Front Matter....Pages 317-317 Microbial hazards in the assembly of intravenous infusions....Pages 319-324 Bacterial contamination of intravenous infusions due to faulty technique....Pages 325-337 The incidence of nosocomial infection in patients receiving total parenteral nutrition....Pages 339-377 Tracing sources of infection associated with parenteral infusions....Pages 379-388 Front Matter....Pages 389-389 Acid-base balance during parenteral nutrition with Travasol....Pages 391-401 Metabolic complications of parenteral nutrition....Pages 403-413 The compatibility of extemporaneously added drug additives with Travasol (amino acid) injection....Pages 415-426 Front Matter....Pages 427-427 Clinical experience of total parenteral nutrition....Pages 429-445 Protein sparing therapy during prolonged ileus....Pages 447-459 Cholestatic jaundice during parenteral alimentation in adults....Pages 461-472 The importance of parenteral nutrition as an adjunct to cancer treatment....Pages 473-499 Artificial nutrition and the gastrointestinal tract: some clinical and experimental data....Pages 501-508 Front Matter....Pages 509-509 The tissue composition of surgical weight loss....Pages 511-519 Research in malnutrition and its application to parenteral feeding....Pages 521-533 The use of body composition measurements to assess the efficacy of parenteral nutrition....Pages 535-555 The use of 40 K counting and its relationship to other estimates of lean body mass....Pages 557-572 Back Matter....Pages 573-581