New developments in total parenteral nutrition for children.
The field of parenteral nutrition continues to evolve along two major paths: prevention of complications and refining of nutritional needs. Parenteral nutrition-associated liver disease remains a vexing problem. No single factor is to blame; rather, it requires a number of "hits." In the infant, the liver disease primarily appears to be related to prematurity of bile flow and production, infection, lack of enteral feedings, and most recently appreciated, perhaps free radicals. We are able to meet the nutritional needs of our patients, but our knowledge of actual nutritional requirements remains incomplete. Future studies need to define better appropriate intakes and to rigorously test the utility of proposed nutrients such as glutamine.
Shulman
R J
RJ
USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital. rshulman@bcm.tmc.edu
D002648:Child; D002779:Cholestasis / Q000209:etiology* / Q000628:therapy; D003545:Cysteine / Q000008:administration & dosage; D005947:Glucose / Q000008:administration & dosage; D005973:Glutamine / Q000008:administration & dosage; D006801:Humans; D015227:Lipid Peroxidation; D008055:Lipids / Q000008:administration & dosage; D010289:Parenteral Nutrition, Total / Q000009:adverse effects* / Q000639:trends*; D014131:Trace Elements / Q000008:administration & dosage
D008055:Lipids; D014131:Trace Elements; D005973:Glutamine; D005947:Glucose; D003545:Cysteine