Intravenous Nutrition Therapy Research Articles

경정맥영양주사치료(intravenous nutrition therapy)의 근거 및 임상적 활용 범위

Intravenous nutrition therapy (IVNT) of functional medicine is often used as a confused concept with amino acid fluids or total parenteral nutrition (TPN) fluids due to its name of nutrition therapy. However, IVNT is a fluid treatment method whose composition and purpose are different from amino acid fluids and TPN fluids. IVNT may be applied to alleviating chronic fatigue, liver detoxification, anticancer effects in cancer patients, or relieving side effects from chemotherapy, depending on its components. IVNT can be applied to restore mitochondrial and adrenal dysfunction for alleviating chronic fatigue, and in the liver detoxification process, IVNT provides therapeutic effects through the supply of essential coenzymes and cofactors required for the liver detoxification phase and also reduces hepatic inflammation through antioxidant effects. Anti-cancer effects can be expected in cancer patients through high-dose antioxidant treatment. It is important for clinicians to select appropriate tests before applying IVNT to patients, and to apply appropriate IVNT through accurate differentiation diagnosis. In addition, Clinicians should familiarize with the precautions for each minerals and vitamins and be able to administer IVNT safely and effectively.

Энтеральная и внутривенная нутриентная поддержка для улучшения репродуктивных исходов

Aim: To describe the tools for determining the nutritional status of patients, possible methods for its correction, the main components (vitamins, macro- and micronutrients, and antioxidants) for oral and intravenous administration, involved in the implementation of the reproductive function. Key points. The correct combination of enteral and parenteral forms of vitamins, macro- and microelements makes it possible to adequately, personalized and quickly compensate for the deficient conditions of patients at the pregravid stage, to ensure a favorable start of pregnancy, taking into account personal risks. The optimal nutritional status maintains normal immunological reactivity of the organism, influencing the processes of implantation and placentation, which is extremely important for overcoming miscarriage, especially in the early stages. Conclusion. Intravenous nutritional support is an additional tool in the practitioners' arsenal to improve reproductive outcomes and improve patients' quality of life. Keywords: vitamins, macro- and micronutrients, preconception preparation, antioxidants, intravenous nutritional therapy.

Effect of axillary vein detained needle in intravenous nutrition

Objective To compare the clinical effects between the axillary vein and the scalp vein or upper limbs vein detained needle when being used for neonatal intravenous nutrition. Methods 100 neonates needing for intravenous nutrition from Januanry 2011 to June 2012 were randomly divided into 2 groups:the axillary vein detained needle group (experiment group), the scalp vein or upper limbs vein detained needle group(control group). Retaining time, crying incidence and complication incidence were compared. Results The retaining time, crying incidence and complication incidence of experiment group were(6.25±1.42)d,8.93% and 12.5%respectively. The retaining time, crying incidence and complication incidence of control group were(3.05±0.86)d,25%and 45.5% respectively. The differences between the two groups were significant. Conclusion The axillary vein detained needle is better than the scalp vein or upper limbs vein detained needle.It can be used widely in clinic. Key words: Axillary vein; Scalp vein; Upper limbs vein; Detained needle; Intravenous nutrition therapy

Tarm- og flerorgantransplantasjon ved kronisk tarmsvikt

Patients with chronic intestinal failure are treated primarily with parenteral nutrition, often for many years. If serious complications arise for intravenous nutritional therapy, it is possible to perform intestinal or multi-organ transplantation in selected patients. We have established a collaboration with Professor Michael Olausson at Sahlgrenska University Hospital in Gothenburg and Professor Andreas Tzakis at the Jackson Memorial Hospital in Miami, USA, to provide an option for Norwegian patients with chronic intestinal failure. Retrospective long-term study of seven patients (five in Gothenburg and two in Miami) with chronic intestinal failure who underwent intestinal or multi-organ transplantation (ventricle, duodenum, pancreas and small intestine) in the period 2001-2009. At the same time, liver and kidney transplantations were performed on six and two patients, respectively. Four of seven patients are alive and have a good quality of life 24-120 months after the transplantation. The graft function is satisfactory, so that the patients' food intake is mainly oral. Three patients died following a serious infection one, ten and 24 months, respectively, after transplantation took place. Intestinal and multi-organ transplantation is a demanding and expensive treatment. Life-long multi-disciplinary follow-up of the patients is necessary after the transplantation in order to ensure early diagnosis of rejection and infections. Collaboration with international centres has given Norwegian patients with chronic intestinal failure an option of transplantation with satisfactory long-term results.

Treatment of Pancreatic Ascites and External Pancreatic Fistulas with a Long-Acting Somatostatin Analogue (Sandostatin)

Prior to the advent of somatostatin conservative therapy for pancreatic fistulas, treatment included intravenous nutritional therapy with nothing per mouth and therapeutic agents to diminish pancreatic secretions. None of these modalities were uniformly successful. A prospective study to evaluate the efficacy of a long-acting somatostatin analogue (Sandostatin) was carried out. 18 patients-10 with pancreatic ascites and 8 with external pancreatic fistulas-were treated. The ascites resolved in 9 of 10 patients in a mean period of 22 days (+/- 3 days). The external fistulas were all high output fistulas and resolved in 7 of 8 patients. Mean period for closure was 23 days. There were no side effects associated with Sandostatin. Sandostatin has made a major impact on the conservative treatment of pancreatic ascites and is an important adjunct to the management of external pancreatic fistulas. It is emphasised however that surgery may be required for the underlying pancreatic disease. In this regard close surveillance of these patients is necessary.

Accuracy of plasma turbidity measurement for determining fat intolerance during total parenteral nutrition

The accuracy of plasma turbidity measurements in predicting ability to metabolise intravenous fat emulsions during total parenteral nutrition was studied in 35 adult surgical patients. Plasma turbidity, expressed as a light scattering index (LSI), was determined by nephelometry and compared with measured triglyceride (TG) concentrations. A poor coefficient of correlation was found between LSI and TG (r = 0.52). The sensitivity and specificity of LSI in predicting TG concentration were 19% and 96% respectively. This indicates that the measurement of LSI is more useful in ruling out hypertriglyceridaemia than in detecting it. Consequently, clinical tolerance of intravenous fat emulsion cannot be monitored by measuring plasma turbidity. In order to avoid metabolic complications which may occasionally occur during intravenous nutritional therapy including fat emulsion, determination of plasma TG levels at timed intervals are recommended.

A comparison of essential and general amino acid infusions in protein-depleted patients receiving parenteral alimentation

Six malnourished patients were studied during intravenous nutrition therapy to compare the efficiency of essential and general amino acids when given as the sole nitrogen source during intravenous nitrogen therapy. A cross-over design was used so that each patient received both essential amino acids plus arginine and histidine and a general amino acid solution in random order. Glucose provided the remainder of the energy and both infusions contained 2 g of amino acid per 100 kcal. Each patient's daily urea nitrogen production was greater during infusion of the general amino acid solution. Consequently, nitrogen intake minus urea nitrogen production was significantly greater when the essential amino acid solution was infused. Plasma amino acid levels were determined on each patient during both essential and general amino acid infusion. Abnormalities tend to reflect the composition of the amino acid solutions as well as their administration directly into the systemic circulation bypassing the portal circulation.

General aspects of intravenous feeding of cancer patients

In order to obtain or maintain a good nutritional status in cancer patients, it is often necessary to perform intravenous nutrition. In summary, several studies have indicated that intravenous nutrition may be beneficial in association with surgery, radiation, or chemotherapy in patients with cancer. More controlled studies, however, are required. There is no indication at the present time of any adverse effects of this method of treatment in relation to tumor growth. The general nutritional improvement in patients on intravenous nutrition increases the immunocompetence, resistance to radiation and cytostatics as well as the mood and quality of life of the cancer patients. In very broad terms this new intravenous nutrition therapy means that a cancer patient should not be left without specific cancer therapy because of starvation and its serious or even fatal complications.