Nitrogen balance in patients receiving either fat or carbohydrate for total intravenous nutrition.

Eighteen pre and/or postoperative patients underwent TIN using either fat or carbohydrate as a caloric substrate source for a similar period. Positive nitrogen balance was achieved with either solution for an equal number of days when balance studies were complete. Both groups demonstrated weight gain but it was more marked in the carbohydrate TIN group. One patient in the carbohydrate TIN group was changed to Intralipid because of a catheter related complication. This patient continued to show positive nitrogen balance while on Intralipid. There were 4 deaths in the 18 patients unrelated to TIN. It is concluded that Intralipid, when given through a peripheral vein with a nitrogen source, can produce positive nitrogen balance and is a safe and effective means for doing this.

Prevention of peritoneal adhesions in the rat. The effects of dexamethasone, methylprednisolone, promethazine, and human fibrinolysin.

Peritoneal adhesions were created in rats by brisk scrubbing of the terminal part of the ileum. Adhesions were graded by total number and the presence of small bowel obstruction. Adhesion prophylaxis was evaluated using dexamethasone, methylprednisolone sodium succinate, promethazine hydrochloride, and human fibrinolysin (Thrombolysin) in various combinations, doses, and routes of administration. Methylprednisolone and dexamethasone, depending on the route of administration, modified the total number of adhesions but did not modify their severity when compared to control animals. Promethazine by itself modified peritoneal adhesions in the rat. Used together, methylprednisolone and promethazine also modified adhesions, but were not substantially better than the combination of dexamethasone and promethazine. Methylprednisolone, promethazine, and human fibrinolyzin, when used in combination intraperitoneally, virtually eliminated adhesion formation.