Touloukian R J
J Pediatr. 1975 Feb;86(2):270-3. doi: 10.1016/s0022-3476(75)80487-2.
Isosmolar coma occurred during the first week of parenteral nutrition in four infants when the amount of protein hydrolysate infused was rapidly increased to or above 4 gm/kg/day. Coma developed within a 6- to 12-hour period and was characterized by (1) a normal serum osmolality, (2) an elevated urine specific gravity, and (3) the rapid reversal of the clinical signs when the protein containing solution was discontinued. A very gradual increase in protein content to a total of no more than 4 gm/kg/day is advised to provide an adequate yet safe protein load for intravenous nutrition.
4名婴儿在肠外营养的第一周出现等渗性昏迷，当时输注的蛋白质水解物量迅速增加至或超过4克/千克/天。昏迷在6至12小时内出现，其特征为：（1）血清渗透压正常；（2）尿比重升高；（3）停用含蛋白质溶液后临床症状迅速逆转。建议将蛋白质含量非常缓慢地增加至总量不超过4克/千克/天，以便为静脉营养提供足够且安全的蛋白质负荷。
