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Advances in Parenteral Nutrition

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (15 July 2018) | Viewed by 19067

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Prof. Dr. Claude Pichard

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Head, Clinical Nutrition, Department of Internal Medicine, University of Geneva, Geneva, Switzerland
Interests: parenteral nutrition; nutrition support; home artificial nutrition

Special Issue Information

Dear Colleagues,

In the early 1970s, the use of parenteral nutrition (PN) became a technicaly-safe option to feed patients with intestinal failure. PN was viewed as a magic treatment, and its use was extended to all patients unable to tolerate sufficient food intake. A decade later, studies reported serious PN-related adverse effects, such as infections, metabolic disturbances, etc. The development of convenient enteral nutrition was then perceived as a much safer treatment. Enteral nutrition quickly became the first choice of feeding for most hospitalized patients, and PN was almost banned from the medical prescriptions. Current guidelines support a more balanced view on the respective advantages and risks of PN and enteral nutrition.

This Special Issue of Nutrients aims at reviewing the indications and limits related to the use of PN in hospitalized patients with acute or chronic pathologies, as well as those on home long term PN. Technical issues related to venous catheters and compounding of the admixtures are also discussed.

Prof. Dr. Claude Pichard
Guest Editor

Manuscript Submission Information

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Keywords

Parenteral nutrition
Nutrition support
Home artificial nutrition

Published Papers (5 papers)

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Research

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14 pages, 2970 KiB

Open AccessArticle

Methionine Partially Replaced by Methionyl-Methionine Dipeptide Improves Reproductive Performance over Methionine Alone in Methionine-Deficient Mice

by Qiong Chen, Wenting Dai, Yalu Sun, Fengqi Zhao, Jianxin Liu and Hongyun Liu

Nutrients 2018, 10(9), 1190; https://doi.org/10.3390/nu10091190 - 01 Sep 2018

Cited by 14 | Viewed by 3953

Abstract

Decreased protein breakdown in pregnant women results in lower concentration of methionine (Met) in plasma, causing pregnancy-related metabolic disturbance. Its dipeptide methionyl-methionine (Met-Met) may exert positive influence in fetal development. This study mainly investigated whether Met-Met can be used as part of free Met to promote reproductive outcomes in mice and the underlying mechanisms. Met-deficient pregnant mice were treated with Met alone or with Met-Met during pregnancy. Daily intraperitoneal injection of 35% dietary Met in pregnant mice was the best dose among the 15–45% doses. Embryo development and newborn birth weight were enhanced when 25% of the Met in the 35% Met group was replaced with Met-Met. Met-Met replacement had higher plasma insulin, glucose, and free amino acids (AA) concentrations. Besides, in the placenta, the AA transporter mRNA abundances and peptide transporters (PhT1 and PepT1) protein levels were higher in Met-Met treatment group. Moreover, Met-Met increased 4E-BP1, S6K1 and AKT/mTOR phosphorylation. These results suggest that Met-Met could be used as a partial source of Met to promote reproductive outcomes in Met-restricted pregnant mice, which might be mediated by promoting nutrient availability and activating AKT/mTOR-mediated signaling pathway. Full article

(This article belongs to the Special Issue Advances in Parenteral Nutrition)

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9 pages, 542 KiB

Open AccessArticle

Nutritional Composition Assessment of 3000 Individualized Parenteral Nutrition Bags in a Tertiary Referral Hospital: Current Prescribing Patterns

by Beatriz Pelegrina-Cortés, Laura M Bermejo, Bricia López-Plaza, Samara Palma-Milla, Natalia García-Vázquez and Carmen Gómez-Candela

Nutrients 2018, 10(8), 1079; https://doi.org/10.3390/nu10081079 - 13 Aug 2018

Cited by 1 | Viewed by 2658

Abstract

Individualized parenteral nutrition is the most specialized type of nutritional support in the hospital setting. The composition and prescribing patterns for parenteral nutrition have evolved due to new emerging scientific evidence. In the last few years, there has been a tendency to increase the nitrogen and lipid content and decrease the carbohydrate content. To assess the prescribing pattern in a tertiary referral hospital in Spain, the nutritional composition of individualized parenteral nutrition was evaluated retrospectively from January to December of 2016. A total of 3029 parenteral nutrition units were analysed, corresponding to 257 hospitalized adult patients. Medical specialists in General Surgery and Haematology were the most common petitioners. The three most frequently prescribed parenteral nutrition formulae contained 13.4 (28.8%), 15.7 (19.54%) and 17.9 (17.79%) g of nitrogen. The quantity of carbohydrates and lipids showed a mean non-protein calories-to-nitrogen ratio of approximately 78:1 and a carbohydrate-to-lipid ratio that was near 50:50 in most cases. These results suggest a trend towards the administration of parenteral nutrition with a high content of nitrogen and smaller proportion of the non-protein components. Full article

(This article belongs to the Special Issue Advances in Parenteral Nutrition)

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10 pages, 2138 KiB

Open AccessArticle

Aluminum Exposure from Parenteral Nutrition: Early Bile Canaliculus Changes of the Hepatocyte

by Amanda R. Hall, Ha Le, Chris Arnold, Janet Brunton, Robert Bertolo, Grant G. Miller, Gordon A. Zello and Consolato Sergi

Nutrients 2018, 10(6), 723; https://doi.org/10.3390/nu10060723 - 04 Jun 2018

Cited by 10 | Viewed by 3726

Abstract

Background: Neonates on long-term parenteral nutrition (PN) may develop parenteral nutrition-associated liver disease (PNALD). Aluminum (Al) is a known contaminant of infant PN, and we hypothesize that it substantially contributes to PNALD. In this study, we aim to assess the impact of Al on hepatocytes in a piglet model. Methods: We conducted a randomized control trial using a Yucatan piglet PN model. Piglets, aged 3–6 days, were placed into two groups. The high Al group (n = 8) received PN with 63 µg/kg/day of Al, while the low Al group (n = 7) received PN with 24 µg/kg/day of Al. Serum samples for total bile acids (TBA) were collected over two weeks, and liver tissue was obtained at the end of the experiment. Bile canaliculus morphometry were studied by transmission electron microscopy (TEM) and ImageJ software analysis. Results: The canalicular space was smaller and the microvilli were shorter in the high Al group than in the low Al group. There was no difference in the TBA between the groups. Conclusions: Al causes structural changes in the hepatocytes despite unaltered serum bile acids. High Al in PN is associated with short microvilli, which could decrease the functional excretion area of the hepatocytes and impair bile flow. Full article

(This article belongs to the Special Issue Advances in Parenteral Nutrition)

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Graphical abstract

7 pages, 201 KiB

Open AccessArticle

Calcium Chloride and Calcium Gluconate in Neonatal Parenteral Nutrition Solutions without Cysteine: Compatibility Studies Using Laser Light Obscuration Methodology

by Robert K. Huston, J. Mark Christensen, Sultan M. Alshahrani, Sumeia M. Mohamed and Carl F. Heisel

Nutrients 2018, 10(2), 208; https://doi.org/10.3390/nu10020208 - 14 Feb 2018

Cited by 6 | Viewed by 4316

Abstract

There are no compatibility studies for neonatal parenteral nutrition solutions without cysteine containing calcium chloride or calcium gluconate using light obscuration as recommended by the United States Pharmacopeia (USP). The purpose of this study was to do compatibility testing for solutions containing calcium chloride and calcium gluconate without cysteine. Solutions of TrophAmine and Premasol (2.5% amino acids), containing calcium chloride or calcium gluconate were compounded without cysteine. Solutions were analyzed for particle counts using light obscuration. Maximum concentrations tested were 15 mmol/L of calcium and 12.5 mmol/L of phosphate. If the average particle count of three replicates exceeded USP guidelines, the solution was determined to be incompatible. This study found that 12.5 and 10 mmol/L of calcium and phosphate, respectively, are compatible in neonatal parenteral nutrition solutions compounded with 2.5% amino acids of either TrophAmine or Premasol. There did not appear to be significant differences in compatibility for solutions containing TrophAmine or Premasol when solutions were compounded with either CaCl₂ or CaGlu-Pl. This study presents data in order to evaluate options for adding calcium and phosphate to neonatal parenteral nutrition solutions during shortages of calcium and cysteine. Full article

(This article belongs to the Special Issue Advances in Parenteral Nutrition)

Review

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8 pages, 233 KiB

Open AccessReview

Non-Antibiotic Antimicrobial Catheter Lock Solutions in Patients on Home Parenteral Nutrition

by Jessica Noelting, Brian Jurewitsch and Johane P. Allard

Nutrients 2018, 10(9), 1165; https://doi.org/10.3390/nu10091165 - 25 Aug 2018

Cited by 12 | Viewed by 3951

Abstract

Patients on home parenteral nutrition (HPN) are dependent on central venous access for long-term sustenance, and catheter-related bloodstream infections (CRBSIs) are a major cause of morbidity and mortality in this patient population. As such, there is much interest in finding new methods for preventing CRBSIs in patients on HPN. As it is thought that these infections are preceded by microbial colonization of the catheter, one approach is to use antimicrobial catheter lock solutions. Although antibiotic catheter lock solutions have been present for decades, their use has been mostly limited to the treatment of CRBSIs due to concern for promoting microbial resistance. Recently, however, with the advent of non-antibiotic antimicrobial catheter lock solutions, this approach is gaining popularity as a promising method to decrease rates of CRBSI in HPN patients. Full article

(This article belongs to the Special Issue Advances in Parenteral Nutrition)

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