Skip to main content

Advertisement

SpringerLink
Log in

Specific topics and complications of parenteral nutrition

  • Current Concepts in Clinical Surgery
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background/Aims

Total parenteral nutrition (TPN) has proven a tremendous advance in all disciplines in medicine but itself introduces a spectrum of possible complications related to both the parenteral nutritional solution as well as the technique of intravenous delivery. Our aim is to review the specific complications of TPN.

Materials and methods

This article presents a critical literature review of relevant topics in TPN-related complications—metabolic, infections, and nutrition related.

Results

Special emphasis focuses on complications of TPN arising from thrombosis or infectious sequelae related to the central venous catheterization and metabolic complications involving the kidneys, bones, liver, and biliary tract.

Conclusions

Awareness and surveillance of TPN-related complications can prevent, potentially, some of these complications related to parenteral nutritional support.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Dudrick SJ, Wilmore DW, Vars HM, Rhoads JE (1968) Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery 64:134–142

    PubMed  CAS  Google Scholar 

  2. Howard L, Ament M, Fleming CR, Shike M, Steiger E (1995) Current use and clinical outcome of home parenteral and enteral nutrition therapies in the United States. Gastroenterology 109:355–365

    PubMed  CAS  Google Scholar 

  3. The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group (1991) Perioperative total parenteral nutrition in surgical patients. N Engl J Med 325:525–532

    Article  Google Scholar 

  4. Buchman AL, Moukarzel A, Goodson B, Herzog F, Pollack P, Reyen L, Alvarez M, Ament ME, Gornbein J (1994) Catheter-related infections associated with home parenteral nutrition and predictive factors for the need for catheter removal in their treatment. JPEN J Parenter Enteral Nutr 18:297–302

    PubMed  CAS  Google Scholar 

  5. Chen HS, Wang FD, Lin M, Lin YC, Huang LJ, Liu CY (2006) Risk factors for central venous catheter-related infections in general surgery. J Microbiol Immunol Infect 39:231–236

    PubMed  Google Scholar 

  6. Reed CR, Sessler CN, Glauser FL, Phelan BA (1995) Central venous catheter infections: concepts and controversies. Intensive Care Med 21:177–183

    PubMed  CAS  Google Scholar 

  7. Maki DG, Weise CE, Sarafin HW (1977) A semiquantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med 296:1305–1309

    Article  PubMed  CAS  Google Scholar 

  8. Cleri DJ, Corrado ML, Seligman SJ (1980) Quantitative culture of intravenous catheters and other intravascular inserts. J Infect Dis 141:781–786

    PubMed  CAS  Google Scholar 

  9. Snydman DR, Murray SA, Kornfeld SJ, Majka JA, Ellis CA (1982) Total parenteral nutrition-related infections. Prospective epidemiologic study using semiquantitative methods. Am J Med 73:695–699

    PubMed  CAS  Google Scholar 

  10. Arnow PM, Quimosing EM, Beach M (1993) Consequences of intravascular catheter sepsis. Clin Infect Dis 16:778–784

    PubMed  CAS  Google Scholar 

  11. Cercenado E, Ena J, Rodriguez-Creixems M, Romero I, Bouza E (1990) A conservative procedure for the diagnosis of catheter-related infections. Arch Int Med 150:1417–1420

    CAS  Google Scholar 

  12. Danzig LE, Short LJ, Collins K, Mahoney M, Sepe S, Bland L, Jarvis WR (1995) Bloodstream infections associated with a needleless intravenous infusion system in patients receiving home infusion therapy. JAMA 273:1862–1864

    PubMed  CAS  Google Scholar 

  13. de Cicco M, Panarello G, Chiaradia V, Fracasso A, Veronesi A, Testa V, Santini G, Tesio F (1989) Source and route of microbial colonisation of parenteral nutrition catheters. Lancet 2:1258–1261

    PubMed  Google Scholar 

  14. Kelly CS, Ligas JR, Smith CA, Madden GM, Ross KA, Becker DR (1986) Sepsis due to triple lumen central venous catheters. Surg Gynecol Obstet 163:14–16

    PubMed  CAS  Google Scholar 

  15. Pemberton LB, Lyman B, Lander V, Covinsky J (1986) Sepsis from triple- vs single-lumen catheters during total parenteral nutrition in surgical or critically ill patients. Arch Surg 121:591–594

    PubMed  CAS  Google Scholar 

  16. Hilton E, Haslett TM, Borenstein MT, Tucci V, Isenberg HD, Singer C (1988) Central catheter infections: single- vs triple-lumen catheters. Influence of guide wires on infection rates when used for replacement of catheters. Am J Med 84:667–672

    PubMed  CAS  Google Scholar 

  17. McCarthy MC, Shives JK, Robison RJ, Broadie TA (1987) Prospective evaluation of single and triple lumen catheters in total parenteral nutrition. JPEN J Parenter Enteral Nutr 11:259–262

    PubMed  CAS  Google Scholar 

  18. Lee RB, Buckner M, Sharp KW (1988) Do multi-lumen catheters increase central venous catheter sepsis compared to single-lumen catheters? J Trauma 28:1472–1475

    Article  PubMed  CAS  Google Scholar 

  19. Farkas JC, Liu N, Bleriot JP, Chevret S, Goldstein FW, Carlet J (1992) Single- versus triple-lumen central catheter-related sepsis: a prospective randomized study in a critically ill population. Am J Med 93:277–282

    PubMed  CAS  Google Scholar 

  20. Gil RT, Kruse JA, Thill-Baharozian MC, Carlson RW (1989) Triple- vs single-lumen central venous catheters. A prospective study in a critically ill population. Arch Int Med 149:1139–1143

    CAS  Google Scholar 

  21. Maki DG, McCormack KN (1987) Defatting catheter insertion sites in total parenteral nutrition is of no value as an infection control measure. Controlled clinical trial. Am J Med 83:833–840

    PubMed  CAS  Google Scholar 

  22. Eyer S, Brummitt C, Crossley K, Siegel R, Cerra F (1990) Catheter-related sepsis: prospective, randomized study of three methods of long-term catheter maintenance. Crit Care Med 18:1073–1079

    PubMed  CAS  Google Scholar 

  23. Widmer AF (1997) Management of catheter-related bacteremia and fungemia in patients on total parenteral nutrition. Nutrition 13:18S–25S

    PubMed  CAS  Google Scholar 

  24. Rannem T, Ladefoged K, Tvede M, Lorentzen JE, Jarnum S (1986) Catheter-related septicaemia in patients receiving home parenteral nutrition. Scand J Gastroenterol 21:455–460

    PubMed  CAS  Google Scholar 

  25. Benoit JL, Carandang G, Sitrin M, Arnow PM (1995) Intraluminal antibiotic treatment of central venous catheter infections in patients receiving parenteral nutrition at home. Clin Infect Dis 21:1286–1288

    PubMed  CAS  Google Scholar 

  26. Messing B, Peitra-Cohen S, Debure A, Beliah M, Bernier JJ (1988) Antibiotic-lock technique: a new approach to optimal therapy for catheter-related sepsis in home-parenteral nutrition patients. JPEN J Parenter Enteral Nutr 12:185–189

    PubMed  CAS  Google Scholar 

  27. Gaillard JL, Merlino R, Pajot N, Goulet O, Fauchere JL, Ricour C, Veron M (1990) Conventional and nonconventional modes of vancomycin administration to decontaminate the internal surface of catheters colonized with coagulase-negative staphylococci. JPEN J Parenter Enteral Nutr 14:593–597

    PubMed  CAS  Google Scholar 

  28. Sitzmann JV, Townsend TR, Siler MC, Bartlett JG (1985) Septic and technical complications of central venous catheterization. A prospective study of 200 consecutive patients. Ann Surg 202:766–770

    PubMed  CAS  Google Scholar 

  29. Hagley MT, Martin B, Gast P, Traeger SM (1992) Infectious and mechanical complications of central venous catheters placed by percutaneous venipuncture and over guidewires. Crit Care Med 20:1426–1430

    PubMed  CAS  Google Scholar 

  30. Pettigrew RA, Lang SD, Haydock DA, Parry BR, Bremner DA, Hill GL (1985) Catheter-related sepsis in patients on intravenous nutrition: a prospective study of quantitative catheter cultures and guidewire changes for suspected sepsis. Br J Surg 72:52–55

    PubMed  CAS  Google Scholar 

  31. Cobb DK, High KP, Sawyer RG, Sable CA, Adams RB, Lindley DA, Pruett TL, Schwenzer KJ, Farr BM (1992) A controlled trial of scheduled replacement of central venous and pulmonary-artery catheters. N Engl J Med 327:1062–1068

    Article  PubMed  CAS  Google Scholar 

  32. Newsome HH Jr, Armstrong CW, Mayhall GC, Sugerman HJ, Miller K, Rich A, Dalton H (1984) Mechanical complications from insertion of subclavian venous feeding catheters: comparison of de novo percutaneous venipuncture to change of catheter over guidewire. JPEN J Parenter Enteral Nutr 8:560–562

    PubMed  Google Scholar 

  33. Wang EE, Prober CG, Ford-Jones L, Gold R (1984) The management of central intravenous catheter infections. Pediatr Infect Dis 3:110–113

    Article  PubMed  CAS  Google Scholar 

  34. King DR, Komer M, Hoffman J, Ginn-Pease ME, Stanley ME, Powell D, Harmel RP Jr (1985) Broviac catheter sepsis: the natural history of an iatrogenic infection. J Pediatr Surg 20:728–733

    PubMed  CAS  Google Scholar 

  35. Dato VM, Dajani AS (1990) Candidemia in children with central venous catheters: role of catheter removal and amphotericin B therapy. Pediatr Infect Dis J 9:309–314

    PubMed  CAS  Google Scholar 

  36. Sitges-Serra A, Linares J, Garau J (1985) Catheter sepsis: the clue is the hub. Surgery 97:355–357

    PubMed  CAS  Google Scholar 

  37. Salzman MB, Rubin LG (1997) Relevance of the catheter hub as a portal for microorganisms causing catheter-related bloodstream infections. Nutrition 13:15S–17S

    PubMed  CAS  Google Scholar 

  38. Stotter AT, Ward H, Waterfield AH, Hilton J, Sim AJ (1987) Junctional care: the key to prevention of catheter sepsis in intravenous feeding. JPEN J Parenter Enteral Nutr 11:159–162

    PubMed  CAS  Google Scholar 

  39. O’Keefe SJ, Burnes JU, Thompson RL (1994) Recurrent sepsis in home parenteral nutrition patients: an analysis of risk factors. JPEN J Parenter Enteral Nutr 18:256–263

    PubMed  CAS  Google Scholar 

  40. Keohane PP, Jones BJ, Attrill H, Cribb A, Northover J, Frost P, Silk DB (1983) Effect of catheter tunnelling and a nutrition nurse on catheter sepsis during parenteral nutrition. A controlled trial. Lancet 2:1388–1390

    PubMed  CAS  Google Scholar 

  41. Rex JH, Bennett JE, Sugar AM, Pappas PG, Serody J, Edwards JE, Washburn RG (1995) NIAID Mycoses Study Group and the Candidemia Study Group: intravascular catheter exchange and duration of candidemia. Clin Infect Dis 21:994–996

    PubMed  CAS  Google Scholar 

  42. Cassidy FP Jr, Zajko AB, Bron KM, Reilly JJ Jr, Peitzman AB, Steed DL (1987) Noninfectious complications of long-term central venous catheters: radiologic evaluation and management. Am J Roentgenol 149:671–675

    Google Scholar 

  43. Hoshal VL Jr, Ause RG, Hoskins PA (1971) Fibrin sleeve formation on indwelling subclavian central venous catheters. Arch Surg 102:253–258

    PubMed  Google Scholar 

  44. Buchman AL, Misra S, Moukarzel A, Ament ME (1994) Catheter thrombosis and superior/inferior vena cava syndrome are rare complications of long term parenteral nutrition. Clin Nutr 13:356–360

    PubMed  CAS  Google Scholar 

  45. Beers TR, Burnes J, Fleming CR (1990) Superior vena caval obstruction in patients with gut failure receiving home parenteral nutrition. JPEN J Parenter Enteral Nutr 14:474–479

    PubMed  CAS  Google Scholar 

  46. Dollery CM, Sullivan ID, Bauraind O, Bull C, Milla PJ (1994) Thrombosis and embolism in long-term central venous access for parenteral nutrition. Lancet 344:1043–1045

    PubMed  CAS  Google Scholar 

  47. Stephens LC, Haire WD, Kotulak GD (1995) Are clinical signs accurate indicators of the cause of central venous catheter occlusion? JPEN J Parenter Enteral Nutr 19:75–79

    PubMed  CAS  Google Scholar 

  48. Haire WD, Lieberman RP (1992) Thrombosed central venous catheters: restoring function with 6-hour urokinase infusion after failure of bolus urokinase. JPEN J Parenter Enteral Nutr 16:129–132

    PubMed  CAS  Google Scholar 

  49. Glynn MF, Langer B, Jeejeebhoy KN (1980) Therapy for thrombotic occlusion of long-term intravenous alimentation catheters. JPEN J Parenter Enteral Nutr 4:387–390

    PubMed  CAS  Google Scholar 

  50. Bern MM, Lokich JJ, Wallach SR, Bothe A Jr, Benotti PN, Arkin CF, Greco FA, Huberman M, Moore C (1990) Very low doses of warfarin can prevent thrombosis in central venous catheters. A randomized prospective trial. Ann Intern Med 112:423–428

    PubMed  CAS  Google Scholar 

  51. Veerabagu MP, Tuttle-Newhall J, Maliakkal R, Champagne C, Mascioli EA (1995) Warfarin and reduced central venous thrombosis in home total parenteral nutrition patients. Nutrition 11:142–144

    PubMed  CAS  Google Scholar 

  52. Gould JR, Carloss HW, Skinner WL (1993) Groshong catheter-associated subclavian venous thrombosis. Am J Med 95:419–423

    PubMed  CAS  Google Scholar 

  53. Griffith GC, Nichols G Jr, Asher JD, Flanagan B (1965) Heparin osteoporosis. JAMA 193:91–94

    PubMed  CAS  Google Scholar 

  54. Lutomski DM, Palascak JE, Bower RH (1987) Warfarin resistance associated with intravenous lipid administration. JPEN J Parenter Enteral Nutr 11:316–318

    PubMed  CAS  Google Scholar 

  55. Werlin SL, Lausten T, Jessen S, Toy L, Norton A, Dallman L, Bender J, Sabilan L, Rutkowski D (1995) Treatment of central venous catheter occlusions with ethanol and hydrochloric acid. JPEN J Parenter Enteral Nutr 19:416–418

    PubMed  CAS  Google Scholar 

  56. Sando K, Fujii M, Tanaka K, Chen K, Yoshida H, Iiboshi Y, Nezu R, Konishi K, Takagi Y, Okada A (1997) Lock method using sodium hydroxide solution to clear occluded central venous access devices. Clin Nutr 16:185–188

    PubMed  CAS  Google Scholar 

  57. Beau P, Matuchansky C (1987) Lipid delivery and catheter obstruction during cyclic total parenteral nutrition. Lancet 2:1095–1096

    PubMed  CAS  Google Scholar 

  58. Hughes CA, Prince A, Dowling RH (1980) Speed of change in pancreatic mass and in intestinal bacteriology of parenterally fed rats. Clin Sci (Lond) 59:329–336

    CAS  Google Scholar 

  59. Johnson LR, Schanbacher LM, Dudrick SJ, Copeland EM (1977) Effect of long-term parenteral feeding on pancreatic secretion and serum secretin. Am J Physiol 233:E524–E529

    PubMed  CAS  Google Scholar 

  60. Hughes CA, Dowling RH (1980) Speed of onset of adaptive mucosal hypoplasia and hypofunction in the intestine of parenterally fed rats. Clin Sci (Lond) 59:317–327

    CAS  Google Scholar 

  61. Clark RM (1976) Evidence for both luminal and systemic factors in the control of rat intestinal epithelial replacement. Clin Sci Mol Med 50:139–144

    PubMed  CAS  Google Scholar 

  62. MacGregor IL, Wiley ZD, Lavigne ME, Way LW (1979) Slowed rate of gastric emptying of solid food in man by high caloric parenteral nutrition. Am J Surg 138:652–654

    PubMed  CAS  Google Scholar 

  63. Casaubon PR, Dahlstrom KA, Vargas J, Hawkins R, Mogard M, Ament ME (1989) Intravenous fat emulsion (intralipid) delays gastric emptying, but does not cause gastroesophageal reflux in healthy volunteers. JPEN J Parenter Enteral Nutr 13:246–248

    PubMed  CAS  Google Scholar 

  64. van der Hulst RR, van Kreel BK, von Meyenfeldt MF, Brummer RJ, Arends JW, Deutz NE, Soeters PB (1993) Glutamine and the preservation of gut integrity. Lancet 341:1363–1365

    PubMed  Google Scholar 

  65. Sedman PC, MacFie J, Palmer MD, Mitchell CJ, Sagar PM (1995) Preoperative total parenteral nutrition is not associated with mucosal atrophy or bacterial translocation in humans. Br J Surg 82:1663–1667

    PubMed  CAS  Google Scholar 

  66. van der Hulst RR, von Meyenfeldt MF, Tiebosch A, Buurman WA, Soeters PB (1997) Glutamine and intestinal immune cells in humans. JPEN J Parenter Enteral Nutr 21:310–315

    PubMed  Google Scholar 

  67. Buchman AL, Moukarzel AA, Bhuta S, Belle M, Ament ME, Eckhert CD, Hollander D, Gornbein J, Kopple JD, Vijayaroghavan SR (1995) Parenteral nutrition is associated with intestinal morphologic and functional changes in humans. JPEN J Parenter Enteral Nutr 19:453–460

    PubMed  CAS  Google Scholar 

  68. Tompkins RK, Waisman J, Watt CM, Corlin R, Keith R (1977) Absence of mucosal atrophy in human small intestine after prolonged isolation. Gastroenterology 73:1406–1409

    PubMed  CAS  Google Scholar 

  69. Iiboshi Y, Nezu R, Kennedy M, Fujii M, Wasa M, Fukuzawa M, Kamata S, Takagi Y, Okada A (1994) Total parenteral nutrition decreases luminal mucous gel and increases permeability of small intestine. JPEN J Parenter Enteral Nutr 18:346–350

    PubMed  CAS  Google Scholar 

  70. Illig KA, Ryan CK, Hardy DJ, Rhodes J, Locke W, Sax HC (1992) Total parenteral nutrition-induced changes in gut mucosal function: atrophy alone is not the issue. Surgery 112:631–637

    PubMed  CAS  Google Scholar 

  71. Li J, Langkamp-Henken B, Suzuki K, Stahlgren LH (1994) Glutamine prevents parenteral nutrition-induced increases in intestinal permeability. JPEN J Parenter Enteral Nutr 18:303–307

    PubMed  CAS  Google Scholar 

  72. Helton WS, Jacobs DO, Bonner-Weir S, Bueno R, Smith RJ, Wilmore DW (1990) Effects of glutamine-enriched parenteral nutrition on the exocrine pancreas. JPEN J Parenter Enteral Nutr 14:344–352

    PubMed  CAS  Google Scholar 

  73. Cochran ST, Pagani JJ, Barbaric ZL (1979) Nephromegaly in hyperalimentation. Radiology 130:603–606

    PubMed  CAS  Google Scholar 

  74. Buchman AL, Moukarzel A, Ament ME, Gornbein J, Goodson B, Carlson C, Hawkins RA (1993) Serious renal impairment is associated with long-term parenteral nutrition. JPEN J Parenter Enteral Nutr 17:438–444

    PubMed  CAS  Google Scholar 

  75. Graf H, Stummvoll HK, Luger A, Prager R (1983) Effect of amino acid infusion on glomerular filtration rate. N Engl J Med 308:159–160

    Article  PubMed  CAS  Google Scholar 

  76. Moukarzel AA, Song MK, Buchman AL, Vargas J, Guss W, McDiarmid S, Reyen L, Ament ME (1992) Excessive chromium intake in children receiving total parenteral nutrition. Lancet 339:385–388

    PubMed  CAS  Google Scholar 

  77. Buchman AL, Moukarzel AA, Ament ME (1995) Excessive urinary oxalate excretion occurs in long-term TPN patients both with and without ileostomies. J Am Coll Nutr 14:24–28

    PubMed  CAS  Google Scholar 

  78. Klein GL, Targoff CM, Ament ME, Sherrard DJ, Bluestone R, Young JH, Norman AW, Coburn JW (1980) Bone disease associated with total parenteral nutrition. Lancet 2:1041–1044

    PubMed  CAS  Google Scholar 

  79. DeFronzo RA, Cooke CR, Andres R, Faloona GR, Davis PJ (1975) The effect of insulin on renal handling of sodium, potassium, calcium, and phosphate in man. J Clin Invest 55:845–855

    PubMed  CAS  Google Scholar 

  80. Bengoa JM, Sitrin MD, Wood RJ, Rosenberg IH (1983) Amino acid-induced hypercalciuria in patients on total parenteral nutrition. Am J Clin Nutr 38:264–269

    PubMed  CAS  Google Scholar 

  81. Ott SM, Maloney NA, Klein GL, Alfrey AC, Ament ME, Coburn JW, Sherrard DJ (1983) Aluminum is associated with low bone formation in patients receiving chronic parenteral nutrition. Ann Int Med 98:910–914

    PubMed  CAS  Google Scholar 

  82. Hurley DL, McMahon MM (1990) Long-term parenteral nutrition and metabolic bone disease. Endocrinol Metab Clin N Am 19:113–131

    CAS  Google Scholar 

  83. Foldes J, Rimon B, Muggia-Sullam M, Gimmon Z, Leichter I, Steinberg R, Menczel J, Freund HR (1990) Progressive bone loss during long-term home total parenteral nutrition. JPEN J Parenter Enteral Nutr 14:139–142

    PubMed  CAS  Google Scholar 

  84. Saitta JC, Ott SM, Sherrard DJ, Walden CE, Lipkin EW (1993) Metabolic bone disease in adults receiving long-term parenteral nutrition: longitudinal study with regional densitometry and bone biopsy. JPEN J Parenter Enteral Nutr 17:214–219

    PubMed  CAS  Google Scholar 

  85. Chan S, McCowen KC, Bistrian BR, Thibault A, Keane-Ellison M, Forse RA, Babineau T, Burke P (1999) Incidence, prognosis, and etiology of end-stage liver disease in patients receiving home total parenteral nutrition. Surgery 126:28–34

    PubMed  CAS  Google Scholar 

  86. Cavicchi M, Crenn P, Beau P, Degott C, Boutron MC, Messing B (1998) Severe liver complications associated with long-term parenteral nutrition are dependent on lipid parenteral input. Transplant Proc 30:2547

    PubMed  CAS  Google Scholar 

  87. Sax HC, Talamini MA, Brackett K, Fischer JE (1986) Hepatic steatosis in total parenteral nutrition: failure of fatty infiltration to correlate with abnormal serum hepatic enzyme levels. Surgery 100:697–704

    PubMed  CAS  Google Scholar 

  88. Robertson JF, Garden OJ, Shenkin A (1986) Intravenous nutrition and hepatic dysfunction. JPEN J Parenter Enteral Nutr 10:172–176

    PubMed  CAS  Google Scholar 

  89. Baker AL, Rosenberg IH (1987) Hepatic complications of total parenteral nutrition. Am J Med 82:489–497

    PubMed  CAS  Google Scholar 

  90. Halsted CH (2004) Nutrition and alcoholic liver disease. Semin Liver Dis 24:289–304

    PubMed  CAS  Google Scholar 

  91. Buchman A (2002) Total parenteral nutrition-associated liver disease. JPEN J Parenter Enteral Nutr 26:S43–S48

    Article  PubMed  CAS  Google Scholar 

  92. Stanko RT, Nathan G, Mendelow H, Adibi SA (1987) Development of hepatic cholestasis and fibrosis in patients with massive loss of intestine supported by prolonged parenteral nutrition. Gastroenterology 92:197–202

    PubMed  CAS  Google Scholar 

  93. Bowyer BA, Fleming CR, Ludwig J, Petz J, McGill DB (1985) Does long-term home parenteral nutrition in adult patients cause chronic liver disease? JPEN J Parenter Enteral Nutr 9:11–17

    PubMed  CAS  Google Scholar 

  94. Reif S, Tano M, Oliverio R, Young C, Rossi T (1991) Total parenteral nutrition-induced steatosis: reversal by parenteral lipid infusion. JPEN J Parenter Enteral Nutr 15:102–104

    PubMed  CAS  Google Scholar 

  95. Meguid MM, Akahoshi MP, Jeffers S, Hayashi RJ, Hammond WG (1984) Amelioration of metabolic complications of conventional total parenteral nutrition. A prospective randomized study. Arch Surg 119:1294–1298

    PubMed  CAS  Google Scholar 

  96. Overett TK, Bistrian BR, Lowry SF, Hopkins BS, Miller D, Blackburn GL (1986) Total parenteral nutrition in patients with insulin-requiring diabetes mellitus. J Am Coll Nutr 5:79–89

    PubMed  CAS  Google Scholar 

  97. McMahon M, Manji N, Driscoll DF, Bistrian BR (1989) Parenteral nutrition in patients with diabetes mellitus: theoretical and practical considerations. JPEN J Parenter Enteral Nutr 13:545–553

    PubMed  CAS  Google Scholar 

  98. Bowyer BA, Miles JM, Haymond MW, Fleming CR (1988) l-Carnitine therapy in home parenteral nutrition patients with abnormal liver tests and low plasma carnitine concentrations. Gastroenterology 94:434–438

    PubMed  CAS  Google Scholar 

  99. Buchman AL, Dubin MD, Moukarzel AA, Jenden DJ, Roch M, Rice KM, Gornbein J, Ament ME (1995) Choline deficiency: a cause of hepatic steatosis during parenteral nutrition that can be reversed with intravenous choline supplementation. Hepatology 22:1399–1403

    PubMed  CAS  Google Scholar 

  100. Buchman AL (2006) Total parenteral nutrition: challenges and practice in the cirrhotic patient. Transplant Proc 38:1659–1663

    PubMed  CAS  Google Scholar 

  101. Lombardi B, Ugazio G, Raick AN (1966) Choline-deficiency fatty liver: relation of plasma phospholipids to liver triglycerides. Am J Physiol 210:31–36

    PubMed  CAS  Google Scholar 

  102. Buchman AL, Ament ME, Sohel M, Dubin M, Jenden DJ, Roch M, Pownall H, Farley W, Awal M, Ahn C (2001) Choline deficiency causes reversible hepatic abnormalities in patients receiving parenteral nutrition: proof of a human choline requirement: a placebo-controlled trial. JPEN J Parenter Enteral Nutr 25:260–268

    PubMed  CAS  Google Scholar 

  103. Gleghorn EE, Merritt RJ, Subramanian N, Ramos A (1986) Phenobarbital does not prevent total parenteral nutrition-associated cholestasis in noninfected neonates. JPEN J Parenter Enteral Nutr 10:282–283

    PubMed  CAS  Google Scholar 

  104. Spurr SG, Grylack LJ, Mehta NR (1989) Hyperalimentation-associated neonatal cholestasis: effect of oral gentamicin. JPEN J Parenter Enteral Nutr 13:633–636

    PubMed  CAS  Google Scholar 

  105. Spagnuolo MI, Iorio R, Vegnente A, Guarino A (1996) Ursodeoxycholic acid for treatment of cholestasis in children on long-term total parenteral nutrition: a pilot study. Gastroenterology 111:716–719

    PubMed  CAS  Google Scholar 

  106. Lindor KD, Burnes J (1991) Ursodeoxycholic acid for the treatment of home parenteral nutrition-associated cholestasis. A case report. Gastroenterology 101:250–253

    PubMed  CAS  Google Scholar 

  107. Teitelbaum DH, Han-Markey T, Drongowski RA, Coran AG, Bayar B, Geiger JD, Uitvlugt N, Schork MA (1997) Use of cholecystokinin to prevent the development of parenteral nutrition-associated cholestasis. JPEN J Parenter Enteral Nutr 21:100–103

    PubMed  CAS  Google Scholar 

  108. Quigley EM, Marsh MN, Shaffer JL, Markin RS (1993) Hepatobiliary complications of total parenteral nutrition. Gastroenterology 104:286–301

    PubMed  CAS  Google Scholar 

  109. Roslyn JJ, Pitt HA, Mann LL, Ament ME, DenBesten L (1983) Gallbladder disease in patients on long-term parenteral nutrition. Gastroenterology 84:148–154

    PubMed  CAS  Google Scholar 

  110. Messing B, Bories C, Kunstlinger F, Bernier JJ (1983) Does total parenteral nutrition induce gallbladder sludge formation and lithiasis? Gastroenterology 84:1012–1019

    PubMed  CAS  Google Scholar 

  111. Dawes LG, Muldoon JP, Greiner MA, Bertolotti M (1997) Cholecystokinin increases bile acid synthesis with total parenteral nutrition but does not prevent stone formation. J Surg Res 67:84–89

    PubMed  CAS  Google Scholar 

  112. Priori P, Pezzilli R, Panuccio D, Nardi R, Gullo L (1997) Stimulation of gallbladder emptying by intravenous lipids. JPEN J Parenter Enteral Nutr 21:350–352

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Faculty of Medicine and “Hospital General de Mexico OD”, National Autonomous University of Mexico (UNAM), Mexico City, Mexico

    Eduardo E. Montalvo-Jave & José L. Zarraga

  2. Transplantation Biology Unit, Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Eduardo E. Montalvo-Jave

  3. Gastroenterology Research Unit, Department of Surgery, Mayo Clinic College of Medicine, 200 First Street SW (AL 2-435), Rochester, MN, USA

    Eduardo E. Montalvo-Jave & Michael G. Sarr

Authors
  1. Eduardo E. Montalvo-Jave
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. José L. Zarraga
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael G. Sarr
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael G. Sarr.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Montalvo-Jave, E.E., Zarraga, J.L. & Sarr, M.G. Specific topics and complications of parenteral nutrition. Langenbecks Arch Surg 392, 119–126 (2007). https://doi.org/10.1007/s00423-006-0133-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-006-0133-6

Keywords

Search

Navigation