Effect Of Total Parenteral Nutrition Research Articles

Effects of Total Parenteral Nutrition on Serum Osmolality and Patent Ductus Arteriosus.

The persistence of high serum osmolality in the early postnatal period is a risk for developing patent ductus arteriosus (PDA). Early aggressive nutrition (EAN), involving total parenteral nutrition (TPN), by which enough concentrations of glucose and amino acids are administered intravenously, is recommended postnatally to improve the neurological prognosis in preterm infants. However, the effects of EAN involving TPN on serum osmolality and the development of a PDA have not been adequately studied. Thus, in this study, we aimed to investigate the impact of TPN on serum osmolality and determine whether increased serum osmolality could be associated with a higher incidence of PDA in preterm infants. In this single-center retrospective observational study, preterm infants born at <28 weeks of gestation who had been admitted to our neonatal intensive care unit (NICU) before (pre-TPN period) and after the introduction of TPN (post-TPN) were included. We reviewed the medical records of these patients, compared the changes in serum osmolality from birth to five days after birth, the clinical background, and the incidence of PDA between these two periods, and analyzed the risk factors. Additionally, the factors affecting the serum osmolality in very preterm infants were examined. The patients who met the intervention criteria of our NICU and received a cyclooxygenase (COX) inhibitor, Indacin® (Nobelpharma, Tokyo, Japan), within seven days after birth were classified as PDA+; those who could not be identified to have PDA flow by echo and did not receive a COX inhibitor were classified as PDA-. The postnatal day and serum sodium (Na+) were statistically significantly correlated with a higher serum osmolality. Serum osmolality remained statistically significantly higher in the PDA+ cohort compared with the PDA- cohort after the first day of life. However, no statistically significant differences were observed in serum osmolality after 24 hours of age, weeks of gestational age, birth weight, or incidence of PDA between the pre- and post-TPN periods. The results of the multiple logistic regression analyses revealed that the increased serum osmolality correlated with PDA development. In this study, the serum Na+ statistically significantly correlated with a higher serum osmolality. Moreover, the increased serum osmolality correlated with PDA development. Thus, the prevention of hypernatremia might reduce the incidence of PDA. Nonetheless, the findings in this study revealed that no statistically significant differences in serum osmolality were observed between the pre-and post-TPN periods, indicating that TPN had little effect on serum osmolality.

Efeitos da nutrição parenteral total associada à glutamina, à fluidoterapia enteral, associada ou não à glutamina, e fluidoterapia sobre o lipidograma de equinos submetidos à inanição após laparotomia

ABSTRACT In order to evaluate the effect of total parenteral nutrition associated with glutamine and enteral fluid therapy, associated or not with glutamine, on the lipidogram of horses subjected to starvation (phase 1) and refeeding (phase 2), 16 adult healthy horses were used, mixed breed, aged between four and fourteen years and average weight of 248.40 ± 2.28kg, divided into four experimental groups, with four animals per group: Group ENTGL: enteral fluid therapy with electrolytes associated with glutamine; Group PARGL: total parenteral nutrition associated with glutamine; Group ENTFL: enteral fluid therapy with electrolytes; and Group PARFL: parenteral fluid therapy. This study was divided into two phases: phase 1 and phase 2. Phase 1 consisted of performing exploratory laparotomy and beginning of starvation, in addition to the administration of treatments, according to the group, while phase 2 consisted of re-feeding the animals. Total cholesterol values remained within the normal range for the species throughout the experimental period, but there was a slight increase during phase 1, followed by a decrease in values in phase 2. Hypertriglyceridemia in the ENFL, ENTGL and PARFL groups during phase 1 occurred because of the negative energy balance. The provision of enteral fluid therapy with electrolytes and an energy source, with or without glutamine, or parenteral fluid therapy were not effective in reversing the effects of negative energy balance. Thus, therapeutic protocols that combine enteral or parenteral fluid therapy for prolonged periods and food deprivation need additional nutritional support to avoid the deleterious effects of negative energy balance.

Potential negative effect of total parenteral nutrition on the human circadian clock.

When patients cannot eat on their own, total parenteral nutrition (TPN) is a clinically beneficial method of maintaining nutrition. However, many animal studies have demonstrated that circadian rhythms are strongly affected by feeding time, raising the concern that continuous TPN around the clock may have an unexpected negative impact on the circadian clock of patients. To investigate this concern, we compared clock gene expression of aged subjects with or without TPN using hair follicle cells and found that while none of the non-TPN subjects showed any obvious defects in circadian rhythms of peripheral clock gene expression, a portion of aged subjects receiving continuous TPN showed abnormal circadian rhythms in peripheral clocks. Continuous TPN around the clock may therefore potentially perturb peripheral circadian rhythms, giving rise to the proposal that TPN needs to be administered with consideration to time factors.

Paralytics and Total Parenteral Nutrition Predict Post-Heart Transplant Mortality in Infants

<h3>Purpose</h3> Many have discussed the perils of "limping to transplant" & have identified risk factors associated with poor heart transplant (HTx) survival. We sought to determine the effect of total parenteral nutrition (TPN)-dependence & paralytics on HTx survival. <h3>Methods</h3> UNOS & PHIS data were used to identify infants listed for HTx (1996-2020) on mechanical ventilation (MV; ≥2 consecutive days pre-HTx), paralytics (insurance-charge on ≥3/5 days pre-HTx), &/or TPN-dependent (insurance-charge for TPN on ≥3/5 days pre-HTx; no charges for oral nutrition on 5/5 days). <h3>Results</h3> 1,425 patients were identified: MV (n=355), paralytics (n=132), and/or TPN (n=351). DCM was more common in those on MV & paralytics, whereas TPN patients had more organ dysfunction & ECMO (p<0.01 for all; Table). 1-year mortality was independently predicted by MV (HR 1.5 (95% CI 1.1-2.0), p=0.01), paralytics (1.8 (1.2-2.8), p<0.01), & TPN (1.6 (1.2-2.2), p<0.01). Requirement for all three was the greatest predictor of mortality (2.3 (1.2-4.4), p<0.01), whereas requirement of none was protective (0.6 (1.2-2.2), p<0.01). As mutually exclusive groups, MV did not independently predict mortality compared to no-support (1.4 (0.9-2.3), p=0.14) or all others (0.7 (0.7-1.7), p=0.69) but all other combinations of TPN, MV, & paralytics were predictive of mortality (p≤0.03 for all; Figure). <h3>Conclusion</h3> Paralytics &/or TPN at transplant independently predicted mortality in infants following HTx. Surprisingly, MV alone was not predictive, although over half of patients on MV were also on paralytics or TPN. This study demonstrates the complexity of what it means to "limp to transplant."

Effects of total parenteral nutrition associated with glutamine, enteral fluid therapy with or without glutamine, and fluid therapy on the acid base and electrolyte balance of horses starved after exploratory laparotomy

This study aimed to evaluate the effects of the total parenteral nutrition associated with glutamine, enteral fluid therapy with or without glutamine, and fluid therapy on the acid–base and electrolyte balance of horses starved after exploratory laparotomy. Sixteen healthy male and female adult horses of mixed breed, aged between 4 and 14 years, and having a mean body weight of 248.40 ± 2.28 kg and a body score index of 3–4 (scale of 1–5) were divided into four groups with four animals per group. After an adaptation period of 30 days, they were randomly divided into four experimental groups: enteral fluid therapy, enteral fluid therapy associated with glutamine, total parenteral nutrition associated with glutamine, and parenteral fluid therapy. The experiment was further divided into two phases: Phase 1 and Phase 2. In Phase 1, an exploratory laparotomy was performed, treatments were administered to the groups and the horses received no food or water other than those given to their respective groups. In Phase 2, the animals were re-fed. Each phase had a total duration of 144 h. Venous blood samples were collected every 24 h throughout the experimental period for blood gas and electrolyte analyses. The following parameters were evaluated: pH, partial pressure of carbon dioxide, total carbon dioxide, bicarbonate, base shift, anion gap, sodium, potassium, chloride, total calcium and magnesium. Completely randomized designs with a 4 × 7 factorial scheme (groups × harvest time) in Phase 1 and a 4 × 6 factorial scheme (groups × harvest time) in Phase 2 were used with four replications. All values were considered significant when p≤0.05 (95% probability). Blood pH, bicarbonate concentration, and base shift in the PARGL group decreased, indicating metabolic acidosis. Changes in the acid–base and electrolyte balance were more intense in the PARGL group than in the other groups. These results demonstrated the need to monitor blood gas and electrolyte balance in horses with food restriction under nutritional support or prolonged fluid therapy so that such changes are promptly corrected.

A systematic review and meta-analysis of the effect of total parenteral nutrition and enteral nutrition on the prognosis of patients with acute pancreatitis.

Nutritional support is very important in the treatment of severe acute pancreatitis, this study aimed to investigate the effect of total parenteral nutrition (TPN) and enteral nutrition (TEN) on the prognosis of patients with acute pancreatitis. The databases of PubMed, Embase, Cochrane Library, and Ovid were searched using the keywords acute pancreatitis, enteral nutrition, and parenteral nutrition to obtain the reports of randomized controlled trials (RCTs) published after 2000. After screening the articles according to the inclusion criteria, risk of bias of the included literatures was evaluated using the Cochrane Handbook for Systematic Reviews. The software RevMan 5.3.5 was used for analysis and the creation of a forest plot and funnel plot. A total of 488 literatures were preliminarily searched in this study, from which 10 articles were included into the final quantitative analysis, involving a total of 699 participants. A total of 6 literatures (n=329 participants) reported the infection rate indicators. The obtained statistic value [odds ratio (OR) =0.25, 95% confidence interval (CI): 0.10 to 0.62] showed TEN had less infection rate that TPN (P=0.003). A total of 8 studies (654 participants) reported the incidence rate indicators of multiple organ failure rate indicator, the obtained statistic value (OR =0.50, 95% CI: 0.24 to 1.08) showed no statistical difference between TEN and TPN (P>0.05). A total of 7 studies (550 participants) reported the mortality indicators. The obtained statistic value (OR =0.59, 95% CI: 0.37 to 0.94) showed TEN had less mortality than TPN (P=0.03). A total of 3 studies reported the length of hospital stay indicators. The obtained statistic value [mean difference (MD) -4.18, 95% CI: -5.07 to -3.30] showed the length of hospital stay for TEN was shorter that TPN (P<0.001). Compared with TPN, TEN can reduce the incidence of infection, reduce the development of multiple organ failure, reduce mortality, and shorten the length of hospital stay in patients with severe acute pancreatitis (SAP). However, attention should be paid to prevent the occurrence of complications during the implementation of nutritional intervention.

Total Parenteral Nutrition for Neonates

&#x0D; The 2 included studies reported conflicting findings regarding weight gain, length, and time to regained birth weight in moderate-to-late preterm neonates weighing 1,500 g or more at birth treated with peripherally administered parenteral nutrition (P-PN) versus 10% dextrose or dextrose-containing fluids. However, both studies reported no statistically significant difference in safety and other measures such as head circumference, time to full enteral feeds, and length of hospital stay between the treatment groups.&#x0D; The strength of the evidence was limited because analyses of the outcomes did not include measures that could minimize false-positive results, and a definitive conclusion could not be drawn regarding the clinical effectiveness of total parenteral nutrition (TPN) for a term or moderate-to-late preterm neonates weighing 1,500 g or more at birth.&#x0D; No relevant evidence-based guidelines regarding using TPN in term or moderate-to-late preterm neonates weighing 1,500 g or more at birth was identified.&#x0D;

Development of a nutritional index to evaluate the effectiveness of total parenteral nutrition during the early postoperative period after pancreaticoduodenectomy.

Malnutrition leads to adverse effects on the short- and long-term prognosis in patients with periampullary diseases who underwent surgery. Nutritional risk indicators based on albumin and body weight have been developed to evaluate nutritional status and nutritional therapy efficacy, but no standard objective measurement has been devised to evaluate nutritional status during the early period after pancreaticoduodenectomy (PD). Therefore, this study aimed to assess the efficacy of total parenteral nutrition (TPN) during the early postoperative period after PD. We analyzed 28 patients with a periampullary disease-common bile duct cancer, ampulla of Vater cancer, pancreatic head cancer, neuroendocrine tumor, chronic pancreatitis-who have undergone PD from Jan. 1, 2012 to Dec. 31, 2016. For all the patients, TPN was administered from postoperative day (POD) 1 at 25 Kcal/kg ideal body weight. Various nutritional indicators were measured such as Body mass index, nutritional risk index, protein, albumin, prealbumin, C-reactive protein. The volume of skeletal muscle area, muscle density, visceral and subcutaneous fat areas were assessed two times, preoperatively and on POD 7 by CT scan at the 3rd lumbar spine (L3) level. Average age of the 28 study subjects (18 males and 10 females) was 63.5±9.7 years. Although there is no difference in BMI between preoperative result and POD 7, protein, albumin, and prealbumin levels were significantly lower POD 7 the preoperative (P<0.001), but CRP was higher (P<0.001), and prealbumin and CRP levels were negatively correlated (R=-0.682, P<0.01). Muscle mass increased postoperatively (P=0.02), but the amount of visceral fat decreased (P=0.00). Based on CRP, and muscle density results, muscle, visceral and subcutaneous fat masses did not change after PD. In order to evaluate the nutritional status accurately after the hepato-biliary radical surgery, we suggest the muscle and fat mass measurement that can adjust the degree of inflammation during the early postoperative period.

The Role of Total Parenteral Nutrition in Patients with Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis.

Simple SummaryPatients with peritoneal carcinomatosis often develop complications which prevent them from receiving adequate oral intake. This can contribute to malnutrition, as well as increased morbidity and mortality. In such patients, total parenteral nutrition, which involves the intravenous administration of nutrients thereby bypassing the oral route, can be lifesaving. In this study, we performed a systematic review and meta-analysis of the existing literature to evaluate the effect of total parenteral nutrition on the survival of patients with peritoneal carcinomatosis. In light of the limited treatment options available, total parenteral nutrition may improve survival outcomes, but further studies are needed to conclude definitively.Peritoneal carcinomatosis (PC) is often associated with malnutrition and an inability to tolerate enteral feeding. Although total parenteral nutrition (TPN) can be lifesaving for patients with no other means of nutritional support, its use in the management of PC patients remains controversial. Therefore, a systematic review and meta-analysis was performed to evaluate the benefit of TPN on the overall survival of PC patients, in accordance with PRISMA guidelines. A total of 187 articles were screened; 10 were included in this review and eight were included in the meta-analysis. The pooled median overall survival of patients who received TPN was significantly higher than patients who did not receive TPN (p = 0.040). When only high-quality studies were included, a significant survival advantage was observed in PC patients receiving TPN (p < 0.001). Subgroup analysis of patients receiving chemotherapy demonstrated a significant survival benefit (p = 0.008) associated with the use of TPN. In conclusion, TPN may improve survival outcomes in PC patients. However, further studies are needed to conclude more definitively on the effect of TPN.

A Comparative Study Evaluating Improvements in Nutritional Status by Oral and Enteral Versus Parenteral Nutrition in Elderly Inpatients of an Emergency Hospital

Aim: Elderly patients hospitalized in the internal medicine department who do not have sufficient oral nutritional intake and fall into low nutrition require artificial hydration and nutrition. Here, the effectiveness of total parenteral nutrition (TPN) was compared to the nutritional administration methods for discharged patients. Methods: 508 elderly inpatients who were admitted to the internal medicine department of an emergency hospital and administered TPN over 9 years were divided into two groups: patients who were discharged (331) and those who died in the hospital (177). Patients were further divided into four groups at the time of discharge from the hospital: oral nutrition, enteral nutrition, peripheral parenteral nutrition and TPN. The effectiveness of TPN was evaluated using serum albumin level and the COntrolling NUTrition Status Score (CONUT) nutritional evaluation tool. Results: While the nutritional status of patients of oral and enteral nutrition improved upon discharge, the CONUT of TPN patients without oral or enteral nutrition did not improve and serum albumin levels of the patients deteriorated. Conclusion: To discharge patients alive and safe, efforts must be made to continue oral and enteral nutrition for as long as possible.

Effects of total parenteral nutrition on drug metabolism gene expression in mice

Parenteral nutrition-associated liver disease (PNALD) is a liver dysfunction caused by various risk factors presented in patients receiving total parenteral nutrition (TPN). Omega-6 rich Intralipid® and omega-3 rich Omegaven® are two intravenous lipid emulsions used in TPN. TPN could affect the hepatic expression of genes in anti-oxidative stress, but it's unknown whether TPN affects genes in drug metabolism. In this study, either Intralipid®- or Omegaven®-based TPN was administered to mice and the expression of a cohort of genes involved in anti-oxidative stress or drug metabolism was analyzed, glutathione (GSH) levels were measured, and protein levels for two key drug metabolism genes were determined. Overall, the expression of most genes was downregulated by Intralipid®-based TPN (Gstp1, Gstm1, 3, 6, Nqo1, Ho-1, Mt-1, Gclc, Gclm, Cyp2d9, 2f2, 2b10, and 3a11). Omegaven® showed similar results as Intralipid® except for preserving the expression of Gstm1 and Cyp3a11, and increasing Ho-1. Total GSH levels were decreased by Intralipid®, but increased by Omegaven®. CYP3A11 protein levels were increased by Omegaven®. In conclusion, TPN reduced the expression of many genes involved in anti-oxidative stress and drug metabolism in mice. However, Omegaven® preserved expression of Cyp3a11, suggesting another beneficial effect of Omegaven® in protecting liver functions.

Nutritional Support of Very Low Birth Weight Infants in a Tertiary Center in a Developing Country.

BackgroundVery low birth weight infants (VLBWIs) are at high risk for nutritional deficiency. Enteral feeding is usually challenged by increased risk of necrotizing enterocolitis (NEC). The nutritional needs of VLBWIs are usually dependent on parenteral nutrition during early postnatal life. This study aimed to evaluate the nutritional service of VLBWIs at Jordan University Hospital.MethodsThis was a prospective follow-up study of VLBWIs with birth weight ≤ 1,500 g. Data were extracted from medical charts and laboratory database.ResultsIn total, 43 VLBWIs met our inclusion criteria; of them, 21% were extremely low birth weight infants (ELBWIs). The mean gestational age was 29 weeks, and the mean birth weight was 1,218 g. The mean age of starting feeds was 3 days. Mean full feed age is 2 weeks. The most common side effect of total parenteral nutrition (TPN) was hypertriglyceridemia (35%).ConclusionsNutritional care of VLBWIs is well established in our center. Initiating fortification earlier and working to increase mother’s own breast milk supply is vital to improve growth in low resource setting.

Total parenteral nutrition versus early enteral nutrition after cystectomy: a meta-analysis of postoperative outcomes.

This study aimed to systematically summarize and analyze the current evidence regarding the effect of total parenteral nutrition (TPN) versus early enteral nutrition (EEN) on postoperative outcomes of cystectomy. A comprehensive search of online databases was conducted to identify comparative studies on the postoperative outcomes of patients receiving TPN and EEN after cystectomy. Our subsequent meta-analysis followed the PRISMA Protocol and the Cochrane Handbook. Five studies with 556 participants were included for meta-analysis. EEN was shown to have a significant effect on reducing the overall complications (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.37-0.75, P < 0.01) and infectious complications (OR 0.32, 95% CI 0.21-0.49, P < 0.01) compared with TPN. Additionally, EEN saved €614-€3120 in costs compared to TPN. There were no significant differences between TPN and EEN groups regarding mortality rate (OR 0.47, 95% CI 0.06-3.51, P = 0.46), the incidence of postoperative ileus (OR 0.90, 95% CI 0.55-1.47, P = 0.68), length of hospital stay (mean difference (MD) 2.12, 95% CI - 0.15 to 4.40, P = 0.07), or time to resume a full diet (MD 1.31, 95% CI - 1.15 to 3.77, P = 0.30). EEN was found to have a significant effect on reducing infectious complications and costs compared with TPN treatment after cystectomy. Remarkably, EEN had no significant impact on mortality incidence, postoperative ileus, length of hospital stay, or the time to resumption of full diet.

The effects of total parenteral nutrition on telomerase expression and in rabbit

The effects of total parenteral nutrition on telomerase expression and in rabbit

Short bowel syndrome results in increased gene expression associated with proliferation, inflammation, bile acid synthesis and immune system activation: RNA sequencing a zebrafish SBS model

BackgroundMuch of the morbidity associated with short bowel syndrome (SBS) is attributed to effects of decreased enteral nutrition and administration of total parenteral nutrition (TPN). We hypothesized that acute SBS alone has significant effects on gene expression beyond epithelial proliferation, and tested this in a zebrafish SBS model.MethodsIn a model of SBS in zebrafish (laparotomy, proximal stoma, distal ligation, n = 29) or sham (laparotomy alone, n = 28) surgery, RNA-Seq was performed after 2 weeks. The proximal intestine was harvested and RNA isolated. The three samples from each group with the highest amount of RNA were spiked with external RNA controls consortium (ERCC) controls, sequenced and aligned to reference genome with gene ontology (GO) enrichment analysis performed. Gene expression of ctnnb1, ccnb1, ccnd1, cyp7a1a, dkk3, ifng1-2, igf2a, il1b, lef1, nos2b, saa1, stat3, tnfa and wnt5a were confirmed to be elevated in SBS by RT-qPCR.ResultsRNA-seq analysis identified 1346 significantly upregulated genes and 678 significantly downregulated genes in SBS zebrafish intestine compared to sham with Ingenuity analysis. The upregulated genes were involved in cell proliferation, acute phase response signaling, innate and adaptive immunity, bile acid regulation, production of nitric oxide and reactive oxygen species, cellular barrier and coagulation. The downregulated genes were involved in folate synthesis, gluconeogenesis, glycogenolysis, fatty-acid oxidation and activation and drug and steroid metabolism. RT-qPCR confirmed gene expression differences from RNA-Sequencing.ConclusionChanges of gene expression after 2 weeks of SBS indicate complex and extensive alterations of multiple pathways, some previously implicated as effects of TPN. The systemic sequelae of SBS alone are significant and indicate multiple targets for investigating future therapies.

Effects of postoperative parenteral nutrition with different lipid emulsions in patients undergoing major abdominal surgery.

PurposeThis study was designed to investigate the effects of total parenteral nutrition (PN) using different lipid emulsions in patients undergoing major abdominal surgery.MethodsFifty-two patients were randomized to receive soybean oil + medium chain triglycerides (MCT) (group I), soybean oil + olive oil (group II), soybean oil + olive oil + fish oil (group III) as a lipid source. PN was started on postoperative day 1 and patients were maintained on PN for a minimum period of 4 days. Laboratory variables (CRP, prealbumin, transferrin) were measured before surgery and on postoperative days.ResultsThree treatment groups were included in the study. Patients in group I received long chain triglycerides (LCT) + LCT/MCT emulsion (%75 LCT + %25 LCT/MCT); Patients in group II received olive oil based emulsion (80% olive oil + 20% soybean oil, ClinOleic); Patients in group III received fish oil in addition to olive oil based emulsion (%85 ClinOleic + %15 Omegaven; Fresenius Kabi). The following 14 parameters were assessed: body weight, CRP, prealbumin, transferrin, tumor necrosis factor-α, interleukin-6, total antioxidant status, thiobarbituric acid reactive substances, oxidized low density lipoprotein-2, complete blood cell, international normalized ratio, D-dimer, activated partially thromboplastin time, prothrombin time. All other parameters showed no differences among the groups.ConclusionThe results of our trial demonstrate a potential beneficial effect of soybean oil/olive oil based lipid emulsions for use in PN regarding inflammatory response and oxidant capacity in the treatment of patients.

Safety of home parenteral nutrition during pregnancy

Few studies have examined the effect of total parenteral nutrition which is lipid-based given throughout pregnancy to patients unable to obtain adequate nutrition by the oral route. In this study we examined the use of lipid-based home parenteral nutrition (HPN) in 7 pregnant women, commenced either before or during pregnancy, and their intra-pregnant course as well as a 2-year follow-up of their offspring is described. HPN was formulated on an individual basis and protein administered in a dose of 0.8-1.1g/kg during the three trimesters. Lipid emulsions included long chain triglycerides or olive-oil based formulae and all patients received trace elements. Data were collected during the course of pregnancy and at birth while infants were followed for a period of between 6 months and 2 years using medical records and questionnaires. In total, we studied 9 pregnancies (in 7 women). HPN was administered for a median of 9 months (range 3-9 months). The mean energy provided during the 1st, 2nd and 3rd trimester was 9297±2797kcal/week, 9148±2629kcal/week and 8564±4059kcal/week resp. The mean increase in weight during the pregnancy was 9±5Kg. The only complications noted during the pregnancy consisted of 3 episodes of catheter-related infections which were successfully treated by antibiotics. The infants were born after a mean of 38.00±1.55 weeks of gestation, with a mean first minute Apgar score of 8.7±1.8 which increased to 9.8±0.4 after 10min. The mean infant birth weight was 2.45±0.37kg. No complications were noted at birth apart from one infant who suffered from torticollis which resolved spontaneously. During follow up, a decrease in hemoglobin related to low iron levels was noted in 1 infant, 2 infants were noted to be allergic to pollen and one underwent a scrotal hernia reduction. No developmental problems have been observed, neither physiological nor psychomotor, over the 2-year follow-up period. The authors suggest, based on, the current study, that lipid-based HPN for pregnant women is a safe method for meeting the nutritional demands of both mother and fetus, and may be administered throughout the pregnancy.

Effectiveness of Total Parenteral Nutrition in Infants` Growth

Effectiveness of Total Parenteral Nutrition in Infants` Growth

Successful management of chylous ascites with total parenteral nutrition and octreotide in children.

To evaluate the effects of total parenteral nutrition and octreotide on pediatric patients with chylous ascites post-operative. Four patients were diagnosed with chylous ascites from Nov 2009 to Nov 2012. Total parenteral nutrition and octreotide was administered to 2 patients, while the other two only received fasting and total parenteral nutrition. All patients had persistent peritoneal drainage, with the quantity and quality of drainage fluid observed daily. Two patients who received somatostatin therapy completely recovered within 7d without any recurrence while on a normal diet. The other two patients who only received fasting and total parenteral nutrition was cured 24-30 d after therapy. Total parenteral nutrition along with octreotide can relieve the symptoms and close the chyle leakage in patients with chylous ascites rapidly. It seems to be an effective therapy available for the treatment of chylous ascites.

Successful management of chylous ascites with total parenteral nutrition and octreotide in children

Purpose: To evaluate the effects of total parenteral nutrition and octreotide on pediatric patients with chylous ascites post-operative. Methods: Four patients were diagnosed with chylous ascites from Nov 2009 to Nov 2012. Total parenteral nutrition and octreotide was administered to 2 patients, while the other two only received fasting and total parenteral nutrition. All patients had persistent peritoneal drainage, with the quantity and quality of drainage fluid observed daily. Results: Two patients who received somatostatin therapy completely recovered within 7d without any recurrence while on a normal diet. The other two patients who only received fasting and total parenteral nutrition was cured 24-30d after therapy. Conclusion: Total parenteral nutrition along with octreotide can relieve the symptoms and close the chyle leakage in patients with chylous ascites rapidly. It seems to be an effective therapy available for the treatment of chylous ascites.