Influence of calorie source on the physiological response to parenteral nutrition in malnourished rabbits

García-Domingo, M.; Lladó, Laura; Franch, G.; Oliva, A; Muñoz, Aída Selfa; Salas, E.; Sancho, Juan José Alegre; Sitges‐Serra, Antonio

doi:10.1016/0261-5614(94)90004-3

Cited by 10 publications

(3 citation statements)

References 19 publications

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“…There is evidence that specific constituents of the TPN solutions may be an important cause of expansion of the extracellular water compartment. Animal (25,26) and human (27,28) studies support the (3 1995 hypothesis that glucose and sodium appear to act synergistically in expanding extracellular water and causing spurious weight gain during parenteral refeeding of malnourished patients. It is worth noting that most patients are administered glucose-based TPN regimens, thus directly introducing into the circulation large amounts of a hypertonic osmotic load.…”

Section: Resultsmentioning

confidence: 86%

Expanded gentamicin volume of distribution in critically ill adult patients receiving total parenteral nutrition

et al. 1995

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Aminoglycoside antibiotics distribute into the extracellular fluid compartment and are eliminated by the kidney via glomerular filtration. Malnutrition and total parenteral nutrition influence the fluid and electrolyte status of the patient, and cause organ changes. The purpose of this clinical study was to characterize the kinetic behaviour of gentamicin in the parenterally fed critically ill adult patient. Eighty-six critically ill adult patients treated with gentamicin for severe Gram-negative infections were enrolled in the study (mean +/- SD): age, 60 +/- 14 years; weight, 69.4 +/- 10.2 kg; height, 163 +/- 10 cm; 22 females and 64 males. Four study groups were defined (2 x 2): total parenteral nutrition vs. fluid therapy, and acute renal failure vs. normal renal function. The drug was administered by intermittent intravenous infusion. Blood samples were drawn at steady-state, 5 min before the next dose ('trough') and 30 min after the termination of the infusion ('peak'). Gentamicin serum concentration was determined by fluorescence polarization immunoassay. Gentamicin pharmacokinetic parameters were estimated by non-linear regression analysis, assuming a one-compartment model and first-order elimination from the central compartment. Treatment of malnutrition with total parenteral nutrition increased gentamicin volume of distribution (P < 0.001), but did not affect total body clearance (P = 0.75). This change tended to produce lower peak concentrations (< 4 micrograms/ml, P = 0.07), thus potentially compromising therapeutic effectiveness. There was no significant influence on trough concentrations (P = 0.56). Patients receiving fluid therapy had a volume of distribution of 0.34 +/- 0.08 litre/kg, while those fed by the intravenous route showed larger values (0.43 +/- 0.12 litre/kg), irrespective of their renal function. This may be explained by the extracellular water expansion caused by stress, malnutrition, and parenteral refeeding. Gentamicin dosage regimens in critically ill adult patients on total parenteral nutrition should be formulated on the basis of larger volumes of distribution and to attain therapeutic serum concentrations higher doses may be required.

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Section: Resultsmentioning

confidence: 86%

Expanded gentamicin volume of distribution in critically ill adult patients receiving total parenteral nutrition

et al. 1995

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“…3). Other authors [7][8][9] later confirmed the sodium-sparing effect of glucose. These studies set up the basis for our current standards of intravenous fluid therapy during short periods of fasting.…”

Section: Thirst Regulation Through Water Balancementioning

confidence: 74%

“…To help elucidate the role of parenteral nutrition formulas in inducing ECW expansion, we investigated the response to refeeding with low-sodium low-water TPN regimens. Animals refed with high-glucose regimens and larger sodium loads exhibited a more positive weight balance largely due to ECW expansion secondary to diminished natriuresis [9,45]. Furthermore, rabbits receiving high-glucose regimens had higher urinary metanephrine excretion, pointing towards increased sympathetic activity as a result of the high-glucose intake.…”

Section: Water and Sodium Retention And Hypoalbuminemiamentioning

confidence: 99%

Water and Sodium Balance: A Nutritional Goal

Sitges‐Serra

2004

Metabolic Issues of Clinical Nutrition

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The effect of an oral glucose load on sodium and water excretion after rapid intravenous infusion of 0.9% (w/v) saline

Lobo¹

2003

Clinical Nutrition

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Influence of calorie source on the physiological response to parenteral nutrition in malnourished rabbits

Cited by 10 publications

References 19 publications

Expanded gentamicin volume of distribution in critically ill adult patients receiving total parenteral nutrition

Expanded gentamicin volume of distribution in critically ill adult patients receiving total parenteral nutrition

Water and Sodium Balance: A Nutritional Goal

The effect of an oral glucose load on sodium and water excretion after rapid intravenous infusion of 0.9% (w/v) saline

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