Hematologic disorders in trauma patients during parenteral alimentation with lipids
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
;
51(2): 60-64, Mar.-Apr. 1996.
Article
in English
| LILACS
| ID: lil-320227
ABSTRACT
Total parenteral nutrition with lipids is a well-accepted modality of metabolic support in seriously ill trauma patients. Intolerance to lipid administration is unusual when dosage limits are not exceeded, and few hematologic disturbances have been recorded with modern fat emulsions. In the course of intravenous alimentation of six adults admitted for traumatic lesions, eosinophilia with or without leukocytopenia was noticed after periods of four days to five weeks. Principal clinical events and hematologic derangements were documented in this population. Sepsis was not always present in the patients by the time of the complication, and in those that did require antibiotics and other drugs, the prescription remained unchanged along the episode. Discontinuation of the nutritional regimen with lipids was followed by normalization of the hematologic profile, suggesting that an acute or sub-acute allergic reaction was responsible. The appearance of skin rash in two occasions reinforces this hypothesis, and the possibility of hemophagocytosis merits consideration in two of the cases who displayed reversible acute leukocytopenia. It is concluded that blood cell aberrations are possible during intravenous feeding with lipids in trauma subjects, but tend to respond to suppression of the lipid-containing nutritional prescription.
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Index:
LILACS (Americas)
Main subject:
Wounds and Injuries
/
Parenteral Nutrition
/
Fat Emulsions, Intravenous
/
Hematologic Diseases
Limits:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Language:
English
Journal:
Rev. Hosp. Clin. Fac. Med. Univ. Säo Paulo
Journal subject:
Medicine
Year:
1996
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Nutrition Group. Hospital das Clínicas de São Paulo/BR
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