Impairment of Pulmonary Macrphage Function with Total Parenteral Nutrition

Shou, Jian; Lappin, Jacqueline; Daly, J.M.

doi:10.1097/00000658-199403000-00009

Cited by 53 publications

(27 citation statements)

References 29 publications

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“…2,3,14 Bacterial translocation, microaspiration of pathogens from the gastrointestinal tract, impaired pulmonary macrophage function, and increased gut permeability have been postulated to be responsible for this susceptibility during IV-TPN feeding. [15][16][17][18][19] Our laboratory has proposed a cogent mechanism for the reduced pneumonia rate in enterally fed patients compared with parenterally fed patients: namely, preservation of IgA-mediated mucosal immunity. 4,5,20 Mucosal immunity, which constitutes approximately 50% of total body immunity, is maintained through complex interactions between T cells, B cells, cytokines, and adhesin molecules.…”

Section: Discussionmentioning

confidence: 99%

Enteral Nutrition Prevents Remote Organ Injury and Death After a Gut Ischemic Insult

Fukatsu¹,

Zarzaur²,

Johnson³

et al. 2001

Annals of Surgery

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Section: Discussionmentioning

confidence: 99%

Enteral Nutrition Prevents Remote Organ Injury and Death After a Gut Ischemic Insult

Fukatsu¹,

Zarzaur²,

Johnson³

et al. 2001

Annals of Surgery

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“…9 TPN or TEN using ED also produces local and systemic immunologic impairment, including degenerative changes within the gut-associated lymphoid tissue and defective host pulmonary antimicrobial immune responses. 12,13 The immunologic impairments cause the infectious complications after BT to become more severe. Therefore, breakdown of the mucosal barrier due to TPN sometimes results in increased infection, which leads to death.…”

Section: Discussionmentioning

confidence: 99%

Small Amount of Low-Residue Diet with Parenteral Nutrition Can Prevent Decreases in Intestinal Mucosal Integrity

et al. 2000

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ObjectiveTo investigate the suitable combination ratio of low-residue diet (LRD) and parenteral nutrition (PN) for nutritional support of surgical patients. Summary Background DataBacterial translocation (BT) is a severe complication of total parenteral nutrition (TPN). However, it is sometimes impossible to supply sufficient amounts of nutrients to surgical patients by the enteral route. The authors reported previously that concomitant use of LRD with PN provided preferable nutritional support for patients undergoing surgery for colorectal cancer. MethodsNinety male Donryu rats were used for three experiments. In experiment 1, rats were divided into two groups to receive TPN or total enteral nutrition with LRD. In experiment 2, rats were divided into six groups, receiving variable amounts of LRD. In experiment 3, rats were divided into five groups to receive isocaloric nutritional support with variable proportions of PN and LRD. Intestinal permeability was assessed by monitoring urinary excretion of phenolsulfonphthalein. BT was assessed in tissue cultures of mesenteric lymph nodes and spleen. ResultsIn experiment 1, increases in intestinal permeability and BT were observed in rats maintained on 7-day TPN, but not in those maintained on total enteral nutrition for up to 14 days. In experiment 2, the changes in body weight of rats were correlated with the dose of LRD. However, the intestinal permeability was increased only in rats receiving LRD at 15 kcal/kg per day. In experiment 3, additive LRD corresponding to 15% of total caloric intake prevented increases in intestinal permeability and BT. ConclusionCombined nutritional therapy consisting of PN and small amounts of LRD can provide better nutritional support than TPN for surgical patients.

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“…II]. TPN solution contained a final concen tration of 4.25% protein-enriched BCAA and 25% glu cose, in addition to electrolytes and multivitamins [10], The TPN solution contained 1,233 kcal/1 and the nonprotein caloriemitrogen ratio was 147:1 keal/g N. The rats received 48-60 ml of the TPN solution ( aver age 250 keal/kg) daily [10,11].…”

Section: Methodsmentioning

confidence: 99%

Effects of Total Parenteral Nutrition Using a Solution Enriched with Branched-Chain Amino Acids on Experimental Pancreatitis in Rats

Alhan

Kucuktulu²,

Erçín³

et al. 1997

Eur Surg Res

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The main purpose of this study was to investigate the influence of total parenteral nutrition enriched with branched-chain amino acids (BCAA) on acute pancreatitis (AP) induced by sodium taurocholate in rats. Total parenteral nutrition (TPN) increased the survival rate and serum calcium, and reduced serum urea, liver transaminase, acid phosphatase and lactate dehydrogenase levels, but it did not change the degree of pancreatic damage or serum amylase. Total plasma amino acid concentration and the concentrations of glutamate, glycine, alanine, taurine, valine, leucine, isoleucine, phenylalanine increased significantly after the induction of AP, but there was no difference between the control and therapy groups. Hyperglycemia occurred during the use of TPN. BCAA-enriched TPN can be used in the treatment of AP with few side effects.

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Impairment of Pulmonary Macrphage Function with Total Parenteral Nutrition

Abstract: Defective host pulmonary antimicrobial immune responses during TPN are associated with intestinal bacterial translocation, and may explain increased infectious complications.

Cited by 53 publications

References 29 publications

Enteral Nutrition Prevents Remote Organ Injury and Death After a Gut Ischemic Insult

Enteral Nutrition Prevents Remote Organ Injury and Death After a Gut Ischemic Insult

Small Amount of Low-Residue Diet with Parenteral Nutrition Can Prevent Decreases in Intestinal Mucosal Integrity

Effects of Total Parenteral Nutrition Using a Solution Enriched with Branched-Chain Amino Acids on Experimental Pancreatitis in Rats

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