Intravenous nutrition. Why, when, and with what?

The catabolic reaction to operation or severe trauma will give rise to a real risk of starvation unless sufficient attention is paid to the patient's energy and nitrogen requirements as well as to his fluid and electrolyte balance. The indications for intravenous nutrition in such cases are outlined and the various preparations available for the supply of energy and nitrogen are detailed. In the planning of an intravenous feeding regimen the patient's daily nitrogen losses must be estimated and a formula is provided for this purpose. The technique of parenteral nutrition is discussed and attention drawn to the various metabolic and complications that may be encountered. Neither hepatic impairment nor renal failure need be regarded as a contra-indication to intravenous feeding.