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Changes in total body water and extracellular fluid volume in infants receiving total parenteral nutrition
Insights
Infants receiving total parenteral nutrition experienced weight gain, but this was primarily due to water retention, not increased body mass. This study clarifies fluid shifts during intravenous nutrition in infants.
Area of Science:
- Pediatric Nutrition
- Body Fluid Dynamics
- Metabolic Research
Background:
- Infant weight gain during total parenteral nutrition (TPN) is debated, with uncertainty regarding whether it reflects true body mass increase or fluid retention.
- Understanding body composition changes is crucial for optimizing nutritional support in infants.
Purpose of the Study:
- To investigate the nature of weight gain in infants receiving intravenous nutrition.
- To differentiate between body mass accretion and water retention as causes of weight gain.
Main Methods:
- Studied 18 infants receiving intravenous nutrition post-surgery.
- Measured total body water using deuterium oxide and extracellular fluid volume using sodium bromide.
- Calculated fluid compartments using dye dilution and analyzed serum samples.
Main Results:
- All infants showed weight gain during the study period.
- Total body water percentage decreased initially then stabilized around 75%.
- Extracellular fluid volume percentage decreased significantly and stabilized around 40%.
Conclusions:
- Weight gain in infants on TPN is predominantly due to water retention rather than an increase in body mass.
- Initial fluid shifts indicate a decrease in extracellular fluid, suggesting altered body composition.
Abstract:
The nature of weight gain seen in infants receiving total parenteral nutrition continues to be controversial. The debate centers around whether or not the weight gain represents an increase in body mass or water retention. The following study was carried out to answer this question. Eighteen infants receiving peripheral or central intravenous nutrition following major surgery were studied for periods ranging from 1 to 17 weeks. The following studies were carried out after receiving informed consent from the parents and in accordance with the standards established by the Human Use Committee. Total body water was measured using the nonradioactive isotope, deuterium oxide; extracellular fluid volume was assayed using the nonradioactive isotope, sodium bromide. Both body fluid compartments were calculated using the Fick principle of dye dilution. Following double vacuum distillation, serum deuterium oxide was assayed using the falling drop technique. Serum bromide was measured by a technique developed in our laboratory that involves the complexing of bromide with gold chloride and the measurement of this chemical complex colorimetrically. Weight gain was observed in all patients. Total body water percent body weight was 82% +/- 15% prior to the initiation of intravenous nutrition; it decreased within the first week to 71% +/- 12% and then stabilized for the remainder of the study period at 75% +/- 7%. The extracellular fluid volume percent body weight was 56% +/- 15% prior to the start of intravenous nutrition; it fell to 47% +/- 10% during the first week of parenteral nutrition, and then stabilized at 40% +/- 9%.(ABSTRACT TRUNCATED AT 250 WORDS)