title: Isosmolar coma during parenteral alimentation with protein hydrolysate in excess of 4 gm/kg/day.
abstract: Isosmolar coma occurred during the first week of parenteral nutrition in four infants when the amount of protein hydrolysate infused was rapidly increased to or above 4 gm/kg/day. Coma developed within a 6- to 12-hour period and was characterized by (1) a normal serum osmolality, (2) an elevated urine specific gravity, and (3) the rapid reversal of the clinical signs when the protein containing solution was discontinued. A very gradual increase in protein content to a total of no more than 4 gm/kg/day is advised to provide an adequate yet safe protein load for intravenous nutrition.
mesh_terms: D000641:Ammonia / Q000097:blood; D001769:Blood; D001806:Blood Urea Nitrogen; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis; D003128:Coma / Q000139:chemically induced / Q000209:etiology* / Q000378:metabolism; D004044:Dietary Proteins / Q000009:adverse effects*; D004386:Duodenum / Q000002:abnormalities; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology*; D008297:Male; D009994:Osmolar Concentration; D010288:Parenteral Nutrition / Q000009:adverse effects*; D011492:Protein Hydrolysates / Q000009:adverse effects*; D013046:Specific Gravity
chemical_list: D002556:Cerebrospinal Fluid Proteins; D004044:Dietary Proteins; D011492:Protein Hydrolysates; D000641:Ammonia