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[Postoperative continuous or cyclic total parenteral nutrition].

J F Zazzo, B Millat

    Annales Francaises D'Anesthesie Et De Reanimation
    |January 1, 1984
    PubMed
    Summary
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    Cyclic total parenteral nutrition (TPN) did not reduce TPN-induced cholestasis in postoperative patients compared to continuous TPN. This study found no significant differences in efficiency or cholestasis incidence between the two TPN methods.

    Area of Science:

    • Gastroenterology
    • Clinical Nutrition
    • Surgical Nutrition

    Background:

    • Inflammatory bowel disease patients receiving total parenteral nutrition (TPN) may develop TPN-induced cholestasis.
    • Cyclic TPN has been hypothesized to reduce the incidence of TPN-induced cholestasis.

    Purpose of the Study:

    • To investigate whether cyclic TPN reduces TPN-induced cholestasis compared to continuous TPN in postoperative patients.

    Main Methods:

    • A prospective randomized trial involving 21 adult patients requiring at least 12 days of postoperative nutrition.
    • Patients were allocated to either continuous or cyclic TPN groups.
    • Nutritional efficiency was assessed by nitrogen balance and prealbumin levels; cholestasis incidence was monitored biologically.

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    Main Results:

    • Nutritional efficiency (nitrogen balance, prealbumin) was comparable between continuous and cyclic TPN groups.
    • Patients on cyclic TPN required increased insulin during the first four postoperative days.
    • The incidence of biological cholestasis was similar in both continuous and cyclic TPN groups.

    Conclusions:

    • This study provides evidence against the benefit of cyclic TPN over continuous TPN in reducing TPN-induced cholestasis in postoperative patients.
    • Larger prospective trials with extended TPN durations are necessary to confirm these findings.