Jpen Parenter Enter
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Jpen Parenter Enter · Jan 1986
Case ReportsShoshin beriberi: an unusual complication of prolonged parenteral nutrition.
After 4 weeks of total parenteral nutrition (TPN), a 12-yr-old girl exhibited an acute heart failure with high cardiac output, anuria, and severe lactic acidosis. The clinical, hemodynamic, and biological data suggested the diagnosis of shoshin beriberi which was proved by the low erythrocyte transketolase activity with elevated "TPP effect" and by the dramatic improvement of the patient after thiamin administration. Thiamin deficiency and severe neurological disorders have been described during long-term parenteral nutrition. To our knowledge, this is the first report of the cardiovascular complication of this vitamin deprivation in long-term TPN.
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Jpen Parenter Enter · Jan 1986
Comparative StudyNormalization of abnormal electroencephalograms in beagles with portacaval anastomosis by infusion of solutions rich in branched-chain amino acids.
The effects of intravenous infusions of amino acid solutions on the electroencephalograms (EEG) and biochemical indices of 12 beagle dogs with a portacaval anastomosis (PCA) were studied in unanesthetized and unrestrained conditions. EEGs were recorded everyday from 2 days after the operation. When the EEGs showed predominant delta and theta frequency bands (slow-wave), solutions of amino acids were infused intravenously at 5 ml/kg/hr for an hour. ⋯ The abnormal EEGs were not improved by infusion with a balanced and AAA-enriched amino acid solution for nutritional support of surgical patients and became worse on infusion of AAA solution. Significant correlations were found between percent changes in the incidence of slow-waves and plasma AAA concentrations. These results suggest that infusion of solution with low AAA and high BCAA concentrations may be suitable for treatment of cirrhotic patients with abnormal EEG or with hepatic encephalopathy.