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Parenteral Nutrition

  • Christian S. Jackson
  • Alan L. Buchman
Part of the Clinical Gastroenterology book series (CG)

Summary

Parenteral nutrition becomes necessary when the gastrointestinal tract has insufficient function as to afford sufficient fluid, electrolyte and nutrient absorption. Indications for this therapy include prolonged postoperative ileus, prolonged intestinal obstruction, short bowel syndrome, various malabsorptive disorders, proximal enteric fistulas for which an enteral feeding tube cannot be placed distal to, severe acute pancreatitis and severe mucositis/esophagitis. Parenteral nutrition, although typically delivered through a large central vein, can also be infused peripherally with special techniques. Rarely, intradialytic parenteral nutrition is required. Parenteral nutrition includes macronutrients (protein in the form of a balanced, free amino acid solution, carbohydrate in the form of a dextrose monohydrate and fat in the form of a lipid emulsion), fluid, electrolytes (sodium, potassium, magnesium and acetate/chloride to adjust pH), minerals (calcium, phosphorous, iron in some individuals), trace minerals (zinc, copper, selenium) and vitamins (water and fat-soluble). Numerous complications may develop as a result of parenteral nutrition including mechanical issues related to the catheter for solution delivery or its insertion, that include infection, occlusion (venous thrombosis or non-thrombotic occlusion), electrolyte disturbances and hyperglycemia, as well as hepatic, renal, pulmonary, and bone complications. Therapy should be appropriately prescribed and rigorously monitored for efficacy and safety.

Keywords

Parenteral nutrition Malnutrition 

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Copyright information

© Humana Press Inc 2008

Authors and Affiliations

  • Christian S. Jackson
  • Alan L. Buchman

There are no affiliations available

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