Practical Metabolic Problems
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Although intravenous infusions were first performed in 1832, for the management of patients with cholera, over one hundred years were to pass before any form of complete nutrition could be provided by this route. Not until the late 1930’s were protein hydrolysates being prepared, and the late 1940’s were fat emulsions being made. In the intervening 30 or so years the practice of parenteral nutrition has expanded widely. In recent years its use has become widespread and includes patients with a great variety of illnesses (13). There are increasing numbers of solutions available for parenteral nutrition, and their use recommended in a variety of ways. Thus it has become common practice, in catabolic patients particularly, to administer throughout the day large amounts of nitrogen in the form of amino acids, and even larger amounts of calories in the form of glucose, other carbohydrates and fat emulsions (24).
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