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Related Experiment Videos

[Reduced parenteral calorie administration after severe multiple injuries].

W Behrendt

    Der Anaesthesist
    |November 1, 1983
    PubMed
    Summary

    Reduced calorie parenteral nutrition in polytraumatized patients, despite low carbohydrates, required insulin and resulted in negative nitrogen balance. However, essential serum proteins remained stable, simplifying infusion therapy.

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    HNO·2003

    Area of Science:

    • Metabolic changes in polytraumatized patients
    • Parenteral nutrition and metabolic disturbances
    • Nutritional support in critical care

    Context:

    • Polytrauma patients often experience significant metabolic derangements.
    • Early nutritional support is crucial for recovery in critically ill patients.
    • Parenteral nutrition is a common method for delivering nutrition in patients unable to eat.
    • Managing metabolic complications like hyperglycemia and negative nitrogen balance is challenging.

    Purpose:

    • To investigate the effects of reduced calorie and normal amino acid parenteral nutrition on carbohydrate and protein metabolism in polytraumatized patients.
    • To assess the feasibility and impact of simplified infusion therapy with restricted carbohydrate dosage.
    • To evaluate the potential for transitioning to combined parenteral/enteral nutrition.

    Summary:

    • Fifteen polytraumatized patients received parenteral nutrition with restricted calories (17 kcal/kg BW) and normal amino acids (1.0 g AA/kg BW) for 5 days.
    • Despite carbohydrate restriction, insulin was required to maintain blood glucose (8-10 mmol/l), and nitrogen balance was negative (-7 to -12 g/day).
    • Unstable serum proteins remained normal, while plasma amino acids showed a post-traumatic pattern, and free fatty acids were elevated. Triglycerides were normal.

    Impact:

    • Reducing carbohydrate dosage in parenteral nutrition can simplify infusion therapy and decrease the risk of metabolic disturbances.
    • This approach allows for a higher percentage of patients (70%) to transition to combined parenteral/enteral nutrition after five days.
    • Findings suggest a potential strategy for optimizing nutritional management in the early post-traumatic phase.

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