Total Parenteral Nutrıtıon

Abstract

An adequate intake of nutrients is necessary to maintain an optimal State of nutrition and health. This is no less true in patienls with trauma, severe bums or majör surgical procedures. Such patients are hypercatabolic, with a marked increase in energy expenditure and nitrogen loss, and are usually anorexic or unable to eaL In some instances,such as injury, surgery or disease of the gastrointestinal tract, oral feeding can aggravate the disease or be detrimental to wound healing. For these reasons, parenteral nutrition is important or sorıietimes the only form of to meet the nutritional needs. In terms of cellular nutrition, it makes little difference whether the nutrients are supplied orally or intravenously. However it should be recognized that with the administration of nutrients directly into the blood circulation, the gastrointestinal tract is being bypassed. In addition, small bowel hypoplasia, changes in gastrointestinal hormone secretion, and decrease intestinal enzyme activity have been observed in animals maintained on total parenteral nutrition. The question has been raiscd, therefore, about the importance or neccessity of direct contact of food to maintain normal morphologic and functional integrity of the gastrointestinal tract. A consideration of such consequences following long term total parenteral nutrition is neccessary in the planning of subsequent oral alimentation.