Banister A, Matin-Siddiqi S A, Hatcher G W, Hendrickse R G
Acta Paediatr Scand. 1975 Sep;64(5):732-40. doi: 10.1111/j.1651-2227.1975.tb03912.x.
42 infants with persistent diarrhoea were fed intravenously using a simplified regime based on Intralipid and an aminoacid, Fructose and ethanol solution. Peripheral veins were used for up to 56 days, and with scalp veins complications were few and minor. The use of arm and leg veins caused more frequent local problems and is not advised. Central venous lines became necessary in 5 infants, and 3 developed septicaemia. The regime was well tolerated with adequate weight gain when intake was adjusted to the infants' needs. Rates of infusion of 1 g Intralipid/kg hourly over 2 hours and up to 1 g fructose/kg hourly over 14 hours did not cause persistent lipaemia (except transiently in 2 infants) nor metabolic acidosis. Infants must be fully rehydrated with correction of acidosis and electrolyte imbalance before starting intravenous feeding, or acidosis and dehydration from osmotic diuresis may occur. Intravenous feeding should be started gradually and cautiously in severely malnourished infants, and should not be used where liver function is abnormal.
42例持续性腹泻婴儿采用基于英脱利匹特(Intralipid)、氨基酸、果糖和乙醇溶液的简化方案进行静脉喂养。外周静脉使用长达56天,使用头皮静脉时并发症少且轻微。使用手臂和腿部静脉导致更频繁的局部问题,不建议使用。5例婴儿需要放置中心静脉导管,3例发生败血症。当摄入量根据婴儿需求进行调整时,该方案耐受性良好,体重增加充足。每2小时以1g英脱利匹特/千克的速度输注,以及每14小时以高达1g果糖/千克的速度输注,不会导致持续性脂血症(2例婴儿有短暂性脂血症)或代谢性酸中毒。在开始静脉喂养前,婴儿必须完全补液并纠正酸中毒和电解质失衡,否则可能会因渗透性利尿导致酸中毒和脱水。对于严重营养不良的婴儿,应逐渐且谨慎地开始静脉喂养,肝功能异常时不应使用。