RESUMO
Twenty pregnant patients needing nutritional support for various indications received hypercaloric, hyperosmotic, "3 in 1," peripheral parenteral nutrition as a bridge to enteral therapy. This system, named total peripheral parenteral nutrition, was evaluated as to tolerance and efficacy in pregnant patients. Patients were in various stages of pregnancy and had an average weight loss of 10.4 pounds prior to admission. Patients were maintained on total peripheral parenteral nutrition for an average of 5 days and gained an average of 4.1 pounds. Good tolerance with minimal side effects of the treatment was noted. Intravenous sites were changed an average of 1.1 times per patient during the course of therapy and only one serious complication was noted in 20 patients. Patients were followed through delivery and this information is presented. Total peripheral parenteral nutrition appears to be an acceptable alternative to conventional total parenteral nutrition to pregnant patients needing nutritional support. These hypertonic solutions can supply total caloric/metabolic needs without unacceptable side effects.
Assuntos
Distúrbios Nutricionais/terapia , Complicações na Gravidez/terapia , Adulto , Estudos de Avaliação como Assunto , Feminino , Humanos , Nutrição Parenteral Total/métodos , Gravidez , Redução de PesoRESUMO
The purpose of this report was to describe the tolerance of hyperosmolar nutritionally complete solutions infused peripherally, as a bridge to enteral therapy in the surgical patient. Solutions providing approximately 40% of calories as carbohydrates were administered to 23 surgical patients with the fats, amino acids, and dextrose mixed in one container. Final osmolarity, when measured directly with additives, ranged from 1200-1350 mOsm/L. Approximately 85% of the patients had acceptable tolerance to this new technique. The patient tolerance of the high osmolar admixture in peripheral veins might be attributed to the buffering and dilution effect of the IV fats in combination with the higher pH of the amino acid solutions and the addition of heparin to the admixture. Strong support for this technique was voiced by experienced nutritional support physicians and hospital personnel for use in surgical patients who have immediate short-term needs.
Assuntos
Alimentos Formulados/análise , Nutrição Parenteral Total/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Ensaios Clínicos como Assunto , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necessidades Nutricionais , Nutrição Parenteral Total/economiaRESUMO
Since more than 60% of patients with cancer at some time will experience pain that requires medical or surgical intervention, pain control is an important priority for these patients. Demand analgesia literally places pain control in the hands of the patient. Based on their experience with patients who have used this system of pain treatment, the authors discuss the therapeutic advantages, economic considerations, and guidelines for use of patient-controlled analgesia.
