Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
Current uses and abuses of total parenteral nutrition.
Adv Surg. 1996;29:165-89. Unique Identifier : AIDSLINE MED/96359653 Archer SB; Burnett RJ; Fischer JE; Department of Surgery, University of Cincinnati Medical Center,; Ohio, USA.
Abstract:
Total parenteral nutrition remains a vital medical intervention, and in our institution it is considered as basic as intravenous fluids, antibiotics, and blood transfusions. As is true of most treatments, there are specific indications as well as associated risks and costs which mandate justification of its use. It is clear that the indications for TPN are diminishing as basic science and clinical studies continue to find increased benefits associated with enteral feeding, and as techniques for initiating enteral nutrition improve. Because of unproven benefits and/or increased complication rates, TPN has lost favor in the treatment of conditions that were previously thought to require parenteral alimentation, such as acute pancreatitis, pediatric and adult burns, critical care, and preoperative use in patients with mild or moderate malnutrition. Despite diminishing indications, TPN continues to generate excitement in some areas as its immunological effects become better defined. The use of TPN in patients with cancer before certain therapies, as well as in the transplant population, remains hopeful. New uses of TPN will result from a better understanding of the cellular and molecular effects of parenteral feeding. In the future, TPN may well be used as a pharmacologic agent rather than as nutritional intervention.
Keywords: Acquired Immunodeficiency Syndrome/THERAPY Acute Disease Adult Burns/THERAPY Child Critical Care Cutaneous Fistula/THERAPY Enteral Nutrition Female Human Inflammatory Bowel Diseases/THERAPY Intestinal Fistula/THERAPY Kidney Failure/THERAPY Liver Failure/THERAPY Neoplasms/THERAPY Nutrition Disorders/EPIDEMIOLOGY/THERAPY Pancreatitis/THERAPY Parenteral Nutrition Parenteral Nutrition, Total/*UTILIZATION Pregnancy Pregnancy Complications/THERAPY Prevalence Short Bowel Syndrome/THERAPY JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
961130
M96B1114
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Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
