Meng H C, Stahlman M T, Otten A, Dolanski E A, Caldwell M D, O'Neill J A
Pediatrics. 1977 May;59(5):699-709.
Thirty-six preterm, sick, low-birth-weight neonates were given either total or partial parenteral nutrition. The patients were divided into three groups according to their birth weights: group A -less than 1,000 gm, 12 patients: group B--between 1,000 and 1,500 gm, 15 patients: group C--more than 1,500 gm, 9 patients. The solution for total parenteral nutrition contained 20% glucose and 2.6% crystalline amino acids plus appropriate amounts of vitamins and minerals. The volume of infusate given was usually 125 ml/kg/day, but varied depending on the clinical condition of the patient; occasionally it was as high as 150 to 175 ml/kg/day. Infusate of one-half strength was administered initially; its concentrations of glucose and amino acids were increased to three quarters and full strength gradually, if tolerated. The solution for total parenteral nutrition was infused into the superior vena cava via a central venous catheter; that for partial parenteral nutrition was given into a peripheral vein to supplement inadequate oral feedings. The period of parenteral nutrition lasted from 5 to 49 days, with an average of 13.2 days. The intake of 500 mg of nitrogen as crystalline amino acids and 100 kcal as glucose was capable of achieving body weight gain. Positive nitrogen balance of various degrees was also observed. Hyperglycemia of a slight to moderate degree was observed in nine patients; only three required insulin therapy. Two patients had thrombotic occlusion of the central venous catheter. The conclusion was reached that total parenteral nutrition or partial parenteral nutrition, when properly managed, is a safe procedure in small, premature infants. The amino acid solution given as a nitrogen source along with adequate calories was effective in promoting weight gain and nitrogen balance; it was apparently well tolerated by low-birth-weight neonates.
36名早产、患病、低体重的新生儿接受了全胃肠外营养或部分胃肠外营养。根据出生体重将患者分为三组：A组——体重低于1000克，12例患者；B组——体重在1000至1500克之间，15例患者；C组——体重超过1500克，9例患者。全胃肠外营养溶液含有20%的葡萄糖和2.6%的结晶氨基酸，外加适量的维生素和矿物质。输注液的量通常为125毫升/千克/天，但根据患者的临床情况而有所不同；偶尔高达150至175毫升/千克/天。最初给予半量强度的输注液；如果耐受，其葡萄糖和氨基酸浓度逐渐增加至四分之三量强度和全量强度。全胃肠外营养溶液通过中心静脉导管注入上腔静脉；部分胃肠外营养溶液则注入外周静脉以补充不足的经口喂养。胃肠外营养的持续时间为5至49天，平均为13.2天。摄入500毫克作为结晶氨基酸的氮和100千卡作为葡萄糖能够实现体重增加。还观察到不同程度的正氮平衡。9例患者出现轻度至中度高血糖；只有3例需要胰岛素治疗。2例患者发生中心静脉导管血栓形成。得出的结论是，全胃肠外营养或部分胃肠外营养，在妥善管理的情况下，对小早产儿来说是一种安全的方法。作为氮源给予的氨基酸溶液与足够的热量一起有效地促进了体重增加和氮平衡；低体重新生儿显然对其耐受性良好。
