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Related Experiment Videos

Clinical experience with three-in-one admixtures administered peripherally.

D F Hoheim, T A O'Callaghan, B J Joswiak

    Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
    |June 1, 1990
    PubMed
    Summary

    This study shows that hyperosmolar (high-osmolarity) nutritionally complete solutions can be safely infused peripherally in surgical patients. This method offers a viable short-term nutritional support option, bridging patients to enteral therapy.

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    Area of Science:

    • Clinical Nutrition
    • Surgical Patient Care
    • Parenteral Nutrition

    Background:

    • Parenteral nutrition is crucial for surgical patients unable to receive enteral feeding.
    • Peripheral venous access is often preferred for short-term nutritional support.
    • Hyperosmolar solutions typically require central venous access.

    Purpose of the Study:

    • To evaluate the tolerance of hyperosmolar (1200-1350 mOsm/L) nutritionally complete solutions administered peripherally.
    • To assess the feasibility of using these solutions as a temporary nutritional bridge in surgical patients.
    • To identify factors contributing to patient tolerance of peripheral infusion.

    Main Methods:

    • Administration of mixed fat, amino acid, and dextrose solutions to 23 surgical patients.

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  • Solutions provided approximately 40% of calories as carbohydrates.
  • Direct measurement of final osmolarity with additives.

    • Main Results:

    • Approximately 85% of patients demonstrated acceptable tolerance to the peripheral infusion technique.
    • Factors potentially contributing to tolerance include IV fat buffering, higher amino acid pH, and heparin addition.
    • Experienced clinicians supported the technique for short-term needs.

    Conclusions:

    • Hyperosmolar nutritionally complete solutions can be tolerated peripherally in surgical patients.
    • This method serves as an effective bridge to enteral therapy for short-term nutritional requirements.
    • The findings support the expanded use of peripheral parenteral nutrition in specific surgical contexts.