The Artificial Gut Concept
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In 1970 we first described a system for self-administration of intravenous nutrition in the home (1, 11). The concept of an artificial gut arose as a logical development following progress in other fields of medicine, in particular, hemodialysis in the home for patients with end-stage renal disease, together with improved techniques of parenteral nutrition in hospitalized patients. Initially, we used the methods of access to the circulation which had proved so successful in patients on hemodialysis; i. e., arteriovenous shunts or fistulas. Unfortunately, patients requiring long-term parenteral nutrition proved to have inadequate peripheral vessels and a high incidence of clotting which limited the usefulness of both shunts and fistulas in such cases. Consequently, we were obliged to design a right atrial catheter which incorporated certain features that made it suitable for long-term use in our patients (2, 9), and this device has been used to obtain access in the majority of cases. Our program is now in its sixth year, and our experience includes over 50 patients treated with long-term home parenteral nutrition (HPN).
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- 1.ATKINS, R. C., VIZZO, G. E., COLE, J. J., BLAGG, C. R., SCRIBNER, B. H.: The artificial gut in hospital and home. Technical improvements. Trans. Amer. Soc. Artif. Intern. Organs 16, 260 (1970)Google Scholar
- 3.BROVIAC, J. W., RIELLA, M. C., SCRIBNER, B. H.: The role of Intralipid in prolonged parenteral nutrition. I. As a caloric substitute for glucose. Amer. J. clin. Nutrit. 29, 255 (1976).Google Scholar
- 8.RIELLA, M. C., IVEY, M., SCRIBNER, B. H.: Prolonged home parenteral nutrition. Arch. Surg. 1976 (In press).Google Scholar
- 10.SCRIBNER, B. H., BROVIAC, J. W., IVEY, M., RIELLA, M. C.: Patient Instruction Manual for Home Use of the Artificial Gut System. University of Washington, 1974.Google Scholar