Update 1987 pp 40-48 | Cite as

Parenteral Nutrition: When and How?

  • S. M. Willatts
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 3)


Nutritional disturbances are extremely common in patients requiring intensive care and such disturbances have far reaching consequences. The critically ill develop a marked stress response to trauma with disturbances of carbohydrate, fat and protein metabolism. Oxygen consumption is increased, fluid overload common and susceptibility to sepsis is very high. The effects of malnutrition are legion. Acute weight loss in excess of 20% is associated with a postoperative mortality of 33%, compared with 3.5% in those who had lost less weight. Malnutrition is generally held, however, to lead to progressive weakness, although the efficacy of perioperative parenteral nutrition in reducing mortality and morbidity has been questioned by Biebuyck [1]. The ability to respond to infection is attributable in part to a group of proteins, leucocyte endogenous mediators, which are reduced in malnutrition and restored by increasing protein intake.


Parenteral Nutrition Total Parenteral Nutrition Rest Energy Expenditure Increase Protein Intake Parenteral Nutrition Group 
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© Springer-Verlag Berlin Heidelberg 1987

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  • S. M. Willatts

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