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J.Jpn. Surg. Soc.. 85(9): 1010-1013, 1984


Report on the annual meeting

TOTAL PARENTERAL NUTRITION IN SURGICAL INFANTS: RECENT PROGRESS AND PROBLEMS

Department of Pediatric Surgery, Juntendo University Hospital, Tokyo, Japan

Yoshinori Hirai, Shiro Hasegawa, Yutaka Sanada, Toshiyuki Nakagawa, Hideo Takamatsu, Akira Toki, Makoto Takinami, Yasuo Yoshizawa, Keiji Iwakiri

1. The frequency of TPN in surgical infants was 242/686 (37.8%) in neonates and 260/2693 (9.7%) in older infants for the past 15 years. The frequent indications of TPN were intestinal atresia, Hirschsprung's diease and esophageal atresia in the neonatal period, and Hirschsprung's disease, pyloric stenosis and biliary atresia in infancy. The effectiveness of TPN was impressively indicated by better survial rate in the infants with massive intestinal resection received TPN.
2. An amino acid solution (Nl-2) was newly devised, based on the analysis of plasma aminograms in 36 infants received TPN with a commercial amino acid solution (Proteamin and, theoretical considerations. It was more useful solution for TPN in 12 young infants.
3. Urinary phosphorus was a considerable parameter for the administration of Vitamin D in TPN.
4. The incidence of TPN-induced hepatic dysfunction was significantly referred to the amount of amino acid in TPN.
5. Closed infusion system with a soft bag and triple bacterial filters in the line was effective for the prevention of sepsis caused by central venous catheter.
6. The nutritional care was important in the treatment of infants with biliary atresia, because generally they had some nutritional defects such as essential fatty acid deficiency, insufficient amino acid metabolism and zinc deficiency.
7. The nutritional care in infants with advanced neuroblasto.na favorably altered the course of the disease.


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