ABSTRACT
42 infants with persistent diarrhoea were fed intravenously using a simplified regime based on Intralipid and an aminoacid, Fructose and ethanol solution. Peripheral veins were used for up to 56 days, and with scalp veins complications were few and minor. The use of arm and leg veins caused more frequent local problems and is not advised. Central venous lines became necessary in 5 infants, and 3 developed septicaemia. The regime was well tolerated with adequate weight gain when intake was adjusted to the infants' needs. Rates of infusion of 1 g Intralipid/kg hourly over 2 hours and up to 1 g fructose/kg hourly over 14 hours did not cause persistent lipaemia (except transiently in 2 infants) nor metabolic acidosis. Infants must be fully rehydrated with correction of acidosis and electrolyte imbalance before starting intravenous feeding, or acidosis and dehydration from osmotic diuresis may occur. Intravenous feeding should be started gradually and cautiously in severely malnourished infants, and should not be used where liver function is abnormal.
Subject(s)
Diarrhea, Infantile , Parenteral Nutrition , Acidosis , Body Weight , Chronic Disease , Humans , Infant , Infant, Newborn , Time Factors , Water-Electrolyte BalanceABSTRACT
Thirty-eight infants with severe hyperosmolar dehydration and hypernatraemia were treated, using three regimens of intravenous fluids: A. 1/2 normal saline, given fast; B.1/2 normal saline given slowly; C. 1/5 normal saline. 28 of the infants were studied in a treatment trial, and it is concluded tha 0-18% saline in 4-3% dextrose, with the early addition of potassium given at a rate of 100 ml/kg estimated rehydrated weight per 24 hours gives satisfactory rehydration within 48 hours, with little risk of convulsions.
