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Comparison of two nutrient admixtures for total parenteral nutrition

The goal of Total Parenteral Nutrition (TPN) is to provide protein and non-protein energy in order to promote nitrogen retention and meet energy requirements. Controversy exists on whether glucose or lipid is the optimal source of non-protein energy. A randomized clinical trial was conducted for one week to compare the effects of TPN providing 34% of non-protein energy as lipid (Group 1; n = 7) to those of hypertonic glucose TPN (Group 2; n = 6). Indices of nitrogen retention, metabolic abnormalities, physiologic stress, and fat clearance were measured. The energy and protein intakes of Group 1 exceeded those of Group 2 from days 0 to 7 (p $<$ 0.05). Nitrogen balance improved significantly in both groups (p $<$ 0.005). Group 1 achieved zero nitrogen balance within two days; Group 2 never achieved net positive nitrogen balance. Significant elevations in insulin levels (p $<$ 0.025) were associated with both TPN admixtures. However, between the two groups the changes in nitrogen balance, albumin, glucose, fructosamine, insulin, liver enzymes, bilirubin, cortisol, and free fatty acid levels were not statistically different. It would appear that the lipid-carbohydrate TPN is more beneficial for patients who require TPN for a short period of time, but due to the small sample size and short study period further research is recommended.

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.69695
Date January 1993
CreatorsAguzzi, Anna
ContributorsMcArdle, A. H. (advisor)
PublisherMcGill University
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
LanguageEnglish
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Formatapplication/pdf
CoverageMaster of Science (School of Dietetics and Human Nutrition.)
RightsAll items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated.
Relationalephsysno: 001382934, proquestno: AAIMM91793, Theses scanned by UMI/ProQuest.

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