The Latent Risk of Acidosis in Commercially Available Total Parenteral Nutrition (TPN) Products: a Randomized Clinical Trial in Postoperative Patients
| Autor: | Akio Itoh, Masato Nagino, Kohji Yano, Kiyofumi Yamada, Toshitaka Nabeshima, Katsuyoshi Kato, Shin-ichi Sugiura, Toshio Fukuoka |
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| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Urinary system Clinical Biochemistry Medicine (miscellaneous) Urine Gastroenterology Blood serum Internal medicine medicine Humans acid-base imbalance Acidosis Nutrition and Dietetics business.industry Metabolic acidosis medicine.disease Surgery Maillard reaction Parenteral nutrition Original Article total parenteral nutrition acidosis medicine.symptom Net acid excretion business Acid–base imbalance |
| Zdroj: | Journal of Clinical Biochemistry and Nutrition |
| ISSN: | 1880-5086 0912-0009 |
| DOI: | 10.3164/jcbn.08-260 |
| Popis: | To evaluate the latent risk of acidosis in commercially available total parenteral nutrition (TPN) products, three types of commercially available TPN products were compared in postoperative patients. Sixty-four hospitalized patients with gastro-intestinal disease who undertook curative gastro intestinal resection were studied prospectively and administered with TPN solutions. Three types of commercially available TPN products were assigned randomly to eligible patients. Serial studies of blood acid-base status, serum electrolytes, and urinary acid-base status were conducted in the three groups administered with different TPN solutions. Patients received appropriate electrolytic solutions on the operation day and TPN solution from 2 to 7 days after operation. There were no differences among any of the serum electrolytes in the three groups. In one group, urinary pH decreased slightly and urinary net acid excretion (NAE) increased significantly after administration. This TPN product contains about 40 mEq/L of non-metabolizable acid to avoid the Maillard reaction that produces a complex of glucose and amino acids. Urinary NAE did not change in the other two groups. These TPN products do not use non-metabolizable acid to adjust pH. The present results suggest that the non-metabolizable acid may be a risk factor of metabolic acidosis. |
| Databáze: | OpenAIRE |
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