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Query: UMLS:C0020505 (hyperphagia)
6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Intravenous hyperalimentation with dextrose can be associated with adverse respiratory and hepatic effects. The purpose of this study was to determine the respiratory and metabolic consequences of fat calories in excess of resting energy expenditure provided both continuously and discontinuously. No significant changes in respiratory mechanics, oxygen consumption, carbon dioxide production, resting energy expenditure, serum substrates, liver function, or nitrogen balance were noted by the addition of 500 kcal of lipid emulsion to dextrose calories sufficient to meet energy requirements. The respiratory quotient declined significantly with the 12- and 24-hour lipid infusions, but persisted for the entire 24 hours only in the latter instance. The sustained and increased (46% v 36%) oxidation of lipid with a 24-hour infusion suggests that a continuous infusion of lipid is preferable to a discontinuous infusion.
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PMID:Metabolic and respiratory effects of continuous and discontinuous lipid infusions. Occurrence in excess of resting energy expenditure. 643 73

The immediate onset of hypermetabolism after a major burn dictates that nitrogen and calories be supplied as early as possible to such patients to prevent the well-documented catabolic state. However, intravenous hyperalimentation is not always possible, and enteral feeding is not usually attempted in the early resuscitative period. Twelve patients with major burns (40% to 70%) were fed nasoduodenally in the early postburn period with a new solution (3.5% Aminosyn, 25% Polycose, and appropriate additions of electrolytes and vitamins). All patients reached positive nitrogen balance in 9.8 +/- 2.3 days, tolerated the feeding extremely well, and had no distention or diarrhea. Metabolic assessment showed remarkable stability. The characteristic signs of hypermetabolism, such as hyperglycemia and hypoinsulinemia or hyperinsulinemia, were absent. Furthermore, there was no persistent neutrophilia or leukocytosis and there was a significant (p less than .01) decrease in the percentage of juvenile neutrophils and a significant (p less than 0.001) increase in absolute lymphocytes between days 0 and 14 of the study. These data indicate that early enteral feeding of Polycose-Aminosyn is safe and well tolerated, and that the small intestine absorbs nutrients readily in the early postburn period, leading to positive nitrogen balance, preventing loss of serum protein, assisting in the maintenance of normal carbohydrate metabolism, and restoring granulocytes and lymphocytes to normal ratios.
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PMID:Early enteral feeding of patients with major burns: prevention of catabolism. 644 Apr 66

Positive nitrogen balance and preservation of body weight and total proteins were demonstrated in 26 patients undergoing extensive upper gastrointestinal operations who were randomized to receive elemental diet by a needle catheter jejunostomy. Infusions were started immediately after operation and continued for 10 days. In 26 patients receiving enteral feedings and 22 intravenous control patients, mean cumulative 10 day nitrogen balance was +11.7 +/- 5.4 and -44.7 +/- 6.5 g, respectively (p = 0.0001). Enterally fed patients lost only 0.02 +/- 0.5 kg of weight compared with 3.8 +/- 0.3 kg in control patients. The only complications were diarrhea in 34 percent of the study patients and one broken catheter. It is probable that the nitrogen and body weight preservation provided by enteral hyperalimentation equals or exceeds that demonstrated for total parenteral nutrition in postoperative patients.
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PMID:Nutritional benefits of immediate postoperative jejunal feeding of an elemental diet. 676 49

A technique for prehepatic infusion of parenteral nutrients is described. Portal vein hyperalimentation allows hepatic modification and control of the infused nutrients before delivery of these substances into the general circulation and theoretically should reduce the incidence of metabolic complications of hyperalimentation. The clinical experience with prehepatic infusions is reported and the metabolic investigations are described. Transumbilical catheters provided prehepatic delivery of parenteral nutrients for 1 month after esophagogastrectomy for esophageal malignancy without serious infection or portal vein thrombosis. Close surveillance of blood glucose and serum osmolarity demonstrated metabolic stability during the infusion period. Nitrogen balance studies showed better nitrogen economy than is achieved by infusion of similar solutions into the central systemic circulation. Indirect calorimetry indicated that the nitrogen used for production of energy was less than the amount supplied by prehepatic infusions. The same basic liver function abnormalities encountered with systemic infusion of hyperalimentation solutions were noted. The patients gained weight after esophagogastrectomy and did not experience the attrition from malnutrition which usually occurs in the first several months after esophageal resection.
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PMID:Prehepatic hyperalimentation. 676 87

The malnourishing effects of cancer and its treatments haveprovided a strong clinical incentive for the nutritional support of cancer patients with intravenous hyperalimentation (IVH), but potential enhancement of tumor growth by additional substrate provision has generated concern. Twenty-five patients undergoing surgical treatment for gastrointestinal cancer were studied on one of two preoperative dietary regimens: ad libitum oral diet or intravenous hyperalimentation. Using a stable isotope tracer, N-glycine, in vivo tissue fractional protein synthesis rates were determined from operative specimens of tumor and normal gastrointestinal tissue. Despite substantial advantage in caloric and protein intake, and nitrogen retention, tumors in IVH-fed patients were synthesizing protein no faster (14.2%/day) than those in orally fed patients (15.1/day). Tumor fractional protein synthesis rates (PSRs) correlated (r = + 0.708, P less than 0.005) with the PSR of the tissues from which they arose. IVH maintained gut PSR at the level occurring in the orally fed patients. Parenteral nutritional support in cancer patients does not maintain protein synthesis rates at levels greater than those present with regular oral diets. Although not a direct measure of tumor growth, these data provide preliminary evidence that optimal nutritional support of the cancer patient may be possible without undesirable stimulation of tumor growth.
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PMID:Protein synthesis dynamics in human gastrointestinal malignancies. 676 89

Management of protein-calorie malnutrition found in 32 patients with severe liver diseases such as fulminant hepatitis and cirrhosis of the liver was carried out using 2 types of synthetic amino acid solution (Hep-OU and Fischer solution) for intravenous and enteral alimentations with rapid monitoring of serum aminogram. Intravenous hyperalimentation of these cases resulted in maintenance of nutritional status with improvement of nitrogen balance and normalization of impaired serum aminogram. During this study, however, nutritional support was initiated only when intractable ascites, upper gastrointestinal bleeding and hepatic encephalopathy were observed. In 2 cases of fulminant hepatitis with sepsis and 3 hepatoma patients with ascites, elemental diet containing maltose and amino acids was used to supply sufficient amounts of nutrients in a minimum volume of water. These techniques with simultaneous monitoring of urinary excretion of 3-methylhistidine and creatinine height index as nutritional parameters make nutritional management easy for patients with liver disease.
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PMID:Nutritional management of patients with severe liver disease by using intravenous hyperalimentation and elemental diet. 676 41

Much effort by many investigators during past few centuries has led to a technique of total intravenous nutrition which can support normal growth, development, and positive nitrogen balance in infants and adults for an indefinite period of time. The current technique of parenteral hyperalimentation is one which is relatively safe and efficacious, but it will undoubtedly undergo changes and modifications as improved methods and materials become available. With judicious application of the technique as a clinical and laboratory investigative and therapeutic tool, new indications for intravenous therapy will continue to expand and extend to practically every medical specialty and into many areas of basic research.
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PMID:[Total parenteral nutrition. Review of the subject]. 677 70

Fifty consecutive surgical patients were included in a randomized prospective study to determine the relative advantages and disadvantages of two types of nutritional support systems: one, selective hyperalimentation, relies on a balanced substrate formula, while the other, standard hyperalimentation, depends on carbohydrate and protein to satisfy the energy requirements of the patient. The patients who received the balanced substrate formula had significantly fewer complications than those receiving standard hyperalimentation, even though both groups achieved positive energy and nitrogen balance. The enhanced safety of selective hyperalimentation suggests its therapeutic superiority as a basic nutritional support system for a busy surgical service.
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PMID:Selective versus standard hyperalimentation. A randomized prospective study. 677 52

Immunocompetence was measured in 320 gastrointestinal surgery patients using the delayed hypersensitivity test. The frequency of complications and death from sepsis was greater (p less than 0,001) in anergic patients (39%) than in patients with normal response (5%). A close correlation was observed between anergy and malnutrition as determined on the basis of biological criteria (triceps skinfold, arm circumference, ratio between actual and deal weights). This double correlation led to study the influence of hyperalimentation on immune response and prognosis. Parenteral hyperalimentation with nitrogen and calories was administered to 26 anergic patients with heavy or complicated intestinal surgery (peritonitis) for from 10 to 37 days (av.: 19, 2 days). One or more test(s) had turned positive by the 10th day in 7 patients; by the 30th day in 16 and by the 69th day in 20. Out of 26 anergic patients, 19 were nutritionally normal; hyperalimentation had no influence on biological criteria and began to modify body measurements only after 17 days; in the 16 anergic malnourished patients,, hypernutrition led to the development of a positive nitrogen balance (3,60 +/- 1,7 days) and to a return within normal range of biological criteria (7,2 +/- 2,3 days), and body measurements (14,3 +/- 9,2 days). Death from sepsis in anergic patients with hyperalimentation was lower (11,2% and 44,4%; p less than 0,01) than in anergic ones without hyperalimentation. Hyperalimentation with nitrogen and calories modified the nutritional status, immunological response and improved prognosis in anergic patients.
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PMID:[Hyperalimentation after digestive surgery: influence on immune state and on prognosis (author's transl)]. 678 Sep 72

The nutritional status of the patient with cancer of the head and neck is subject to multiple stress. The nutritional status of such a patient is an admixture of the patient's personal hygiene, his or her neoplasm, the treatment of his or her neoplasm, and the complications of such treatment. It has been suggested the restoration of positive nitrogen balance through aggressive nutritional hyperalimentation will restore immunocompetence, enhance the clinical response to treatment, and reduce the frequency of complications. Despite this anecdotal data, controlled studies are needed to show that significant benefit to the patient will justify the added costs of nutritional support in terms of manpower costs, additional days of hospitalization, and increased monies spent on elemental diets.
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PMID:The nutrition problem in head and neck cancer. 678 36


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