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[Parenteral nutrition: indications and techniques].
1Service d'Hépato-Gastroentérologie et d'Assistance Nutritive, et Centre Agréé de Nutrition Parentérale à Domicile, Hôpital Lariboisière-Saint-Lazare, 2, rue Ambroise-Paré, 75475 Paris Cedex 10. bernard.messing@lrb-ap-hop-paris.fr
Annales De Medecine Interne
|February 15, 2001
Summary
Parenteral nutrition is crucial for managing malnutrition in bowel diseases, addressing issues like motility disorders and poor absorption. Strict protocols and dedicated nutritional teams ensure safe and effective treatment for acute and chronic conditions.
Area of Science:
- Gastroenterology
- Clinical Nutrition
- Internal Medicine
Context:
- Malnutrition is a significant complication in patients with acute or chronic bowel diseases.
- Pathophysiological mechanisms include motility disorders and defective absorption.
- Parenteral nutrition is a key intervention for specific gastrointestinal conditions.
Purpose:
- To outline the indications and protocols for parenteral nutrition in bowel disease.
- To emphasize the importance of a structured approach to nutritional support.
- To highlight the role of nutritional teams in optimizing patient outcomes.
Summary:
- Total parenteral nutrition (TPN) is indicated for occlusive intestinal stenosis, complete food intolerance, severe colitis, high-flow digestive fistulae, and inflammatory bowel disease.
- Parenteral nutrition can supplement oral or enteral intake when insufficient or poorly tolerated.
- Both peripheral and central parenteral nutrition require complete, protocol-driven administration to mitigate risks.
Impact:
- Implementing standardized protocols and nutritional teams improves the efficacy and safety of parenteral nutrition.
- This approach minimizes iatrogenic and metabolic risks, enhancing the risk/benefit ratio.
- Recognizing nutritional therapy as a major medical discipline is facilitated by rigorous standards.