Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eleven plasma proteins were compared for each of three groups of 10 closely matched patients before and 15 days after rectal excision who were receiving an addition to oral diets the following parenteral solutions by central venous catheter: 1) no hyperalimentation, 2) hypertonic glucose plus amino acids, or 3) amino acids alone. Plasma transferrin, prealbumin, and retinol-binding protein were normal before surgery in all but seven patients. Postoperatively, concentrations were decreased, but were restored to normal after full hyperalimentation whereas they were significantly less and lower than normal in controls and patients receiving amino acids. Acute phase proteins were higher than normal before surgery and also 15 days later. Lower values in patients receiving hyperalimentation were mainly due to hydration compared with higher values in the other groups caused by the higher incidence of sepsis. It is concluded that full hyperalimentation after major surgery restores "visceral" proteins more rapidly than by infusion of amino acids alone and is associated with fewer clinical complications.
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PMID:Plasma proteins in patients receiving intravenous amino acids or intravenous hyperalimentation after major surgery. 8 26

A consecutive series of 25 patients who developed external small bowel fistula within 2 weeks of abdominal surgery is described. Half the patients had a primary diagnosis of inflammatory bowel disease and the fistula arose usually as a result of direct trauma to the bowel or the breakdown of an anastomosis. All the patients were treated conservatively with total bowel rest and intravenous hyperalimentation. In 15 (60 per cent) spontaneous fistula closure occurred, in an average period of 32 days. In 8 patients the fistula failed to close and surgery was performed, but was effective in only 3 cases. Thus the fistula eventually closed in 18 patients. Five patients died, all from intra-abdominal sepsis. Of the 8 patients with a primary diagnosis of Crohn's disease, 3 died, 2 have a persistent fistula, 1 has a permanent ileostomy and spontaneous closure occurred in only 2.
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PMID:Postoperative external small bowel fistulas: a study of a consecutive series of patients treated with intravenous hyperalimentation. 10 92

A case of polymicrobial sepsis occurred in a patient who had a permanent indwelling hyperalimentation catheter. Because it was undesirable to remove the catheter, quantitative bacteriologic techniques were used to determine whether the catheter was the source of sepsis. Blood drawn from a peripheral vein had 25 colonies per milliliter whereas blood drawn through the catheter had more than 10,000 colonies per milliliter. On the basis of these results, the catheter was removed. The catheter tip was found to be infected with the same organisms that were present in the blood. Quantitative bacteriologic techniques may prove useful in diagnosing catheter-related sepsis when it is undesirable to remove the catheter.
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PMID:Use of quantitative bacteriologic techniques to diagnose catheter-related sepsis. 10 70

In over 1000 cancer patients treated with intravenous hyperalimentation (IVH), tumor growth has not been identified and catheter-related sepsis has been minimal. Studies in rats demonstrated that the host benefits more than the tumor during nutritional repletion, and any stimulation of tumor growth in the rat-tumor model could be manipulated with DNA specific drugs to benefit the host. A study of 65 malnourished cancer patients undergoing oncologic therapy and treated with IVH indicated that much of the immune suppression in these patients was the result of malnutrition coincident with or secondary to oncologic treatment. Conclusions reached in this study were that nutritional repletion resulted in a return of skin test reactivity, proper wound healing in the surgical patient, and possibly an increase in response to chemotherapy. Certainly, the use of IVH allowed specific oncologic therapy to be administered to a group of malnourished patients who otherwise might not have been acceptable candidates for intensive antineoplastic therapy.
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PMID:Nutrition, cancer, and intravenous hyperalimentation. 10 87

Eight patients with intrathoracic esophageal disruptions were managed nonoperatively and without pleural drainage. Criteria for nonoperative treatment included the following: disruption contained in the mediastinum or between the mediastinum and visceral lung pleura; drainage of the cavity back into the esophagus; minimal symptoms; and minimal signs of clinical sepsis. Cause of the esophageal perforation was pneumostatic dilatation (1 patient), vomiting (2), and a leak following esophageal operation (5). Antibiotics were administered intravenously to all patients; hyperalimentation was accomplished intravenously in 5, and nasogastric suction was used in only 1. The cavities contracted and the esophageal leaks sealed in all instances. Time before oral intake was resumed ranged from 7 to 38 days (average, 18 days). Days until discharge ranged from 15 to 52 days (average, 28 days).
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PMID:Selective nonoperative management of contained intrathoracic esophageal disruptions. 11 Feb 75

Hematogenous Candida osteomyelitis is described in a two-month-old infant, as a complication of Candida septicemia which occurred during a parenteral hyperalimentation regimen. Treatment with flucytosine led to full recovery. The scarcity of reports on hematogenous Candida osteomyelitis in infants, despite an increased incidence of Candida septicemia, and the non-specific symptomatology which the disease may assume in this age group, indicate the need for greater awareness of this complication. Flucytosine is an antifungal drug which can also be given by mouth and carries relatively low toxicity. We found flucytosine to be extremely effective in the treatment of disseminated infantile Candida osteomyelitis.
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PMID:Candida osteomyelitis as a complication of parenteral nutrition in an infant. Successful treatment with flucytosine. 11 Jul 30

Home hyperalimentation is now recognized as a technique which allows patients with severe short bowel syndrome or inflammatory bowel disease to return to a near normal life style. The success of this program is dependent on the longterm use of a catheter through which intravenous fluids are infused. In the past 20 months, we have inserted 32 catheters into 22 patients for purposes of home parenteral nutrition. In a 1 to 20-month follow-up, the average duration of catheter insertion was 6 months, the longest has been 19 months in 2 patients. One patient with superior vena cava thrombosis has had a catheter inserted via a femoral vein which has been functioning well for 5 months. Thirteen catheters have been removed: 3 for obstruction, 2 for sepsis, 1 due to breakage of the catheter, 4 for slippage (3 were pulled out by the patient, and 1 was removed because of inability to psychologically accept the presence of the catheter). The removal of 6 of these 13 catheters was necessitated by breaks in the proper techniques of catheter care, which include daily dressing changes and heparinization of the catheter at least once daily. Techniques of catheter insertion and catheter care will be presented
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PMID:Exerience with the Broviac catheter for prolonged parenteral alimentation. 11 Sep 52

This paper represents an extensive review, spanning 30 years of experience with 404 patients with gastrointestinal fistulas. It includes the first period (1945-1960) during the introduction of antibiotics, the second period (1960-1970) which saw rapid improvements in parasurgical care including, respiratory support, perfection of antibiotics, some introduction of nutritional support and improved monitoring, and the third period which saw the introduction of parenteral nutrition specifically central venous hyperalimentation using hypertonic glucose and amino acids (1970-1975) in the treatment of patients with fistulas. The principal causes for mortality in the historical sense were malnutrition, sepsis and electrolyte imbalance. Mortality among patients with gastrointestinal cutaneous fistulas decreased between the first and second periods from approximately 48 to 15%. Surprisingly, mortality did not decrease further in the "hyperalimentation period" although spontaneous closure of gastrointestinal fistulase increased. The results suggest that the improvement in mortality in patients with gastrointestinal cutaneous fistulas is mostly due to the introduction of improved parasurgical care. It is acknowledged that nutritional support was practiced in the 1960's although this was generally not in the form of hyperalimentation. The addition of hyperalimentation in large scale to the treatment of gastrointestinal cutaneous fistulas has improved spontaneous closure and is a valuable part of the armamentarium. The decrease in mortality however, cannot be attributed to parenteral nutrition.
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PMID:Review of 404 patients with gastrointestinal fistulas. Impact of parenteral nutrition. 11 38

Cancer cachexia should no longer be a contraindication to adequate antineoplastic treatment. Current methods of nutritional assessment allow one to identify malnutrition and to follow the nutritional status of the patient throughout the cancer-management program. Enteral nutritional repletion and maintenance remain the ideal course of action, but the gastrointestinal tract is not always readily available or advisable for use; in such circumstances, intravenous hyperalimentation (IVH) may be indicated. The properly nourished patient better tolerates cancer therapy, experiences fewer complications of malnutrition (e.g., sepsis and poor wound healing), and has a better-functioning immune system than does his malnourished counterpart. This article reviews methods of nutritional assessment, delineates indications and techniques for nutritional repletion, and summarizes the results obtained.
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PMID:Nutritional concepts in the treatment of head and neck malignancies. 11 11

In a 5 year period, eight patients in whom acute acalculous cholecystitis developed during intravenous hyperalimentation are reviewed with emphasis on factors contributing to pathogenesis. Gallbladder distention, biliary stasis, and bile inspissation, thought to be important in the pathogenesis of this disease, are enhanced with the use of hyperalimentation, and this potential complication is being seen with increasing frequency in seriously ill or injured patients who are being fed parenterally. In addition to hyperalimentation, sepsis, hypotension, multiple transfusions (more than 10 units), prolonged fasting, and ventilatory support were frequent common denominators. Typical findings of pain, tenderness, and a mass in the right upper abdominal quadrant are infrequent, and the diagnosis rests on a high index of suspicion and ultrasonography. This syndrome may be preventable by the stimulation of gallbladder emptying with intermittent fat ingestion or parenteral infusion of cholecystokinin.
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PMID:Acute acalculous cholecystitis: a complication of hyperalimentation. 11 61


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