Hyperalimentation
Hyperalimentation
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营养过剩
DOI：
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发表时间：
1974
期刊：
影响因子：
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通讯作者：
J. Kinney
中科院分区：
文献类型：
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作者：
J. Kinney
高营养一词由美国的Dudrick引入，通常用于表示高渗溶液的中心静脉给药，通常由氨基酸氮和碳水化合物以及维生素和矿物质的某种组合组成。Dudrick博士利用了宾夕法尼亚大学Jonathan罗兹博士早期的研究，该研究试图避免在外周静脉中给予浓缩溶液的并发症。由于将塑料导管插入上级腔静脉以监测中心静脉压的日益流行，Dudrick博士利用这一途径给予高渗溶液以补充营养。上级腔静脉的大血流量和高渗溶液的快速稀释防止了血管壁的静脉炎，并允许持续缓慢地给予营养素，希望有最佳的利用机会。由于在美国没有可用于静脉内使用的商业脂肪制剂，Dudrick博士在20世纪60年代中期选择了该组合物。其他人认为，如果不是比蛋白质水解酶稍好的话，它们也被利用。然而，使用葡萄糖作为主要的热量来源意味着不可能商业上制备具有延长的保存期的葡萄糖和氨基酸的混合物，因为在这种混合物中自发地发生布朗宁反应。因此，使用这种氮源和葡萄糖的人必须在使用前不久将它们混合。其他碳水化合物溶液如糖醇在欧洲广泛使用，但在美国尚未普及。碳水化合物如山梨糖醇的优点是允许工厂在最佳条件下将其与氨基酸混合，而不需要护士或其他工作人员在使用前立即混合。
The term hyperalimentation was introduced by Dudrick in the United States and has been commonly used to represent central venous administration of hypertonic solutions, usually made up of some combination of amino acid nitrogen and carbohydrate together with vitamins and minerals. Dr. Dudrick took advantage of earlier research with Dr. Jonathan Rhodes at the University of Pennsylvania which sought to avoid the complications of giving concentrated solutions in a peripheral vein. Because of the rising popularity of introducing a plastic catheter into the superior vena cava for monitoring central venous pressure, Dr. Dudrick took advantage of this route to administer hypertonic solutions for nutrition. The large blood flow and rapid dilution of the hypertonic solution in the superior vena cava prevented phlebitis in the wall of the blood vessel and allowed continuous slow administeration of nutrients in the hope that there would be the optimum chance for utilization. This composition was selected by Dr. Dudrick in the middle 1960’s as the result of not having a commercial fat preparation available for intravenous use in the United States. others suggests that these are utilized as well, if not slightly better, than the protein hydrolysades. However, the use of glucose as the main calorie source means that it is not possible to commercially prepare the mixtures of glucose and amino acids with a prolonged shelf life because of the browning reaction which spontaneously occurs in such mixtures. Therefore people using this source of nitrogen together with glucose have had to mix them shortly before use. Other carbohydrate solutions such as the sugar alcohols are used extensively in Europe but have not gained popularity in the United States. A carbohydrate such as Sorbitol@ does have the advantage of allowing the factory to mix it with amino acids under optimum conditions and not requiring mixing by the nurses or other staff shortly before use.