Nutrition
-
The effect of peripheral parenteral nutrition (PPN) on voluntary food intake was examined in healthy male subjects. Each study (lasting 17 to 19 days) was divided into three phases: Ringer's lactate (RL); PPN administered as a combination of glucose, fat, and amino acids; and finally RL. ⋯ When PPN was infused, subjects reduced their food intake within 48 hours by approximately 80% of the infused calories (p less than 0.001) within 48 hours, whereas intake was reduced by less than 40% of the infused calories when BCPPN was infused. Use of branched-chain amino acid-enriched parenteral nutrition may minimize the reduction in food intake seen during intravenous nutrition, possibly hastening a return to normal eating.
-
Meta Analysis
Fuel utilization in neoplastic disease: implications for the use of nutritional support in cancer patients.
Tumor cell metabolism and the whole-body response to tumor metabolic activity produces a complex derangement, including alterations in carbohydrate oxidation with futile cycling and changes in gluconeogenesis and lipid utilization. An interplay between circulating hormones, lymphocyte-mediated cytokines, and tumor growth factors complicates fuel metabolism in these individuals. ⋯ Therefore, it is impossible to determine the validity of the results. Furthermore, it is possible that some of the detrimental effects of TPN observed in earlier studies were secondary to the inappropriate use of large glucose loads in cancer patients.
-
Randomized Controlled Trial Clinical Trial
Total parenteral nutrition in the cancer patient: the present as viewed from the past.
-
Despite numerous controlled clinical trials, the indications for parenteral nutritional support of cancer patients undergoing chemotherapy remain controversial. The results of the published trials have therefore been subjected to meta-analysis. ⋯ In summary, for the patients in trials to date, TPN was associated with net harm. Routine use of TPN in patients undergoing chemotherapy should be strongly discouraged, and trials involving specific groups of patients or modifications in TPN should be undertaken with caution.