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Comparison of enteral feeding and total parenteral nutrition after liver transplantation

Summary Total parenteral nutrition is used for nutritional support in patients undergoing orthotopic liver transplantation but is associated with complications. We compared the efficacy and tolerability of early enteral feeding with total parenteral nutrition after liver transplantation. 24 patients... Full description

Journal Title: The Lancet (British edition) 1994, Vol.344 (8926), p.837-840
Main Author: Wicks, C
Other Authors: Routley, D , Williams, R , Somasundaram, S , Bjarnason, I , Potter, D , Tan, K.C , Menzies, I.S
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: London: Elsevier Ltd
ID: ISSN: 0140-6736
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title: Comparison of enteral feeding and total parenteral nutrition after liver transplantation
format: Article
creator:
  • Wicks, C
  • Routley, D
  • Williams, R
  • Somasundaram, S
  • Bjarnason, I
  • Potter, D
  • Tan, K.C
  • Menzies, I.S
subjects:
  • 3-O-Methylglucose
  • Abridged Index Medicus
  • Adolescent
  • Adult
  • Anthropometry
  • Biological and medical sciences
  • Enteral feeding
  • Enteral Nutrition - methods
  • Evaluation
  • Female
  • Food and nutrition
  • Humans
  • Intestinal Absorption
  • Liver
  • Liver Transplantation
  • Liver, biliary tract, pancreas, portal circulation, spleen
  • Male
  • Medical research
  • Medical sciences
  • Methylglucosides - urine
  • Middle Aged
  • Nutrition
  • Nutritional Status
  • Organ transplant recipients
  • Parenteral feeding
  • Parenteral Nutrition, Total - methods
  • Postoperative Care
  • Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
  • Surgery of the digestive system
  • Transplantation
  • Transplants & implants
  • Xylose - urine
ispartof: The Lancet (British edition), 1994, Vol.344 (8926), p.837-840
description: Summary Total parenteral nutrition is used for nutritional support in patients undergoing orthotopic liver transplantation but is associated with complications. We compared the efficacy and tolerability of early enteral feeding with total parenteral nutrition after liver transplantation. 24 patients were studied: 14 received enteral feeding and 10 total parenteral nutrition. A double-lumen enteral tube was used to deliver the feed directly into the jejunum with the second lumen of the tube being used for gastric aspiration. Enteral feeding was started post-operatively within 18 h, was well-tolerated, and of comparable efficacy to total parenteral nutrition. The median number of days for patients to start eating (4) and to achieve 70% of estimated requirements orally (5) did not differ significantly between the two groups. Mid-arm circumference, triceps skinfold thickness, and biceps skinfold thickness were, by comparison with pre-operative values, maintained on the tenth postoperative day in both groups. Early postoperative absorptive capacity, as assessed by a combined carbohydrate test, was reduced significantly in both groups but insufficiently to be of nutritional concern. Intestinal mucosal integrity, as assessed by an intestinal permeability test, was maintained throughout. We conclude that the practical aspects of enteral feeding after liver transplantation are surmountable and that enteral feeding is as effective at maintaining nutritional status as total parenteral nutrition, and has potential benefits in terms of reduced complications and costs.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0140-6736
fulltext: fulltext
issn:
  • 0140-6736
  • 1474-547X
url: Link


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creatorWicks, C ; Routley, D ; Williams, R ; Somasundaram, S ; Bjarnason, I ; Potter, D ; Tan, K.C ; Menzies, I.S
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descriptionSummary Total parenteral nutrition is used for nutritional support in patients undergoing orthotopic liver transplantation but is associated with complications. We compared the efficacy and tolerability of early enteral feeding with total parenteral nutrition after liver transplantation. 24 patients were studied: 14 received enteral feeding and 10 total parenteral nutrition. A double-lumen enteral tube was used to deliver the feed directly into the jejunum with the second lumen of the tube being used for gastric aspiration. Enteral feeding was started post-operatively within 18 h, was well-tolerated, and of comparable efficacy to total parenteral nutrition. The median number of days for patients to start eating (4) and to achieve 70% of estimated requirements orally (5) did not differ significantly between the two groups. Mid-arm circumference, triceps skinfold thickness, and biceps skinfold thickness were, by comparison with pre-operative values, maintained on the tenth postoperative day in both groups. Early postoperative absorptive capacity, as assessed by a combined carbohydrate test, was reduced significantly in both groups but insufficiently to be of nutritional concern. Intestinal mucosal integrity, as assessed by an intestinal permeability test, was maintained throughout. We conclude that the practical aspects of enteral feeding after liver transplantation are surmountable and that enteral feeding is as effective at maintaining nutritional status as total parenteral nutrition, and has potential benefits in terms of reduced complications and costs.
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languageeng
publisherLondon: Elsevier Ltd
subject3-O-Methylglucose ; Abridged Index Medicus ; Adolescent ; Adult ; Anthropometry ; Biological and medical sciences ; Enteral feeding ; Enteral Nutrition - methods ; Evaluation ; Female ; Food and nutrition ; Humans ; Intestinal Absorption ; Liver ; Liver Transplantation ; Liver, biliary tract, pancreas, portal circulation, spleen ; Male ; Medical research ; Medical sciences ; Methylglucosides - urine ; Middle Aged ; Nutrition ; Nutritional Status ; Organ transplant recipients ; Parenteral feeding ; Parenteral Nutrition, Total - methods ; Postoperative Care ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Transplantation ; Transplants & implants ; Xylose - urine
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descriptionSummary Total parenteral nutrition is used for nutritional support in patients undergoing orthotopic liver transplantation but is associated with complications. We compared the efficacy and tolerability of early enteral feeding with total parenteral nutrition after liver transplantation. 24 patients were studied: 14 received enteral feeding and 10 total parenteral nutrition. A double-lumen enteral tube was used to deliver the feed directly into the jejunum with the second lumen of the tube being used for gastric aspiration. Enteral feeding was started post-operatively within 18 h, was well-tolerated, and of comparable efficacy to total parenteral nutrition. The median number of days for patients to start eating (4) and to achieve 70% of estimated requirements orally (5) did not differ significantly between the two groups. Mid-arm circumference, triceps skinfold thickness, and biceps skinfold thickness were, by comparison with pre-operative values, maintained on the tenth postoperative day in both groups. Early postoperative absorptive capacity, as assessed by a combined carbohydrate test, was reduced significantly in both groups but insufficiently to be of nutritional concern. Intestinal mucosal integrity, as assessed by an intestinal permeability test, was maintained throughout. We conclude that the practical aspects of enteral feeding after liver transplantation are surmountable and that enteral feeding is as effective at maintaining nutritional status as total parenteral nutrition, and has potential benefits in terms of reduced complications and costs.
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03-O-Methylglucose
1Abridged Index Medicus
2Adolescent
3Adult
4Anthropometry
5Biological and medical sciences
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7Enteral Nutrition - methods
8Evaluation
9Female
10Food and nutrition
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17Medical research
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19Methylglucosides - urine
20Middle Aged
21Nutrition
22Nutritional Status
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24Parenteral feeding
25Parenteral Nutrition, Total - methods
26Postoperative Care
27Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
28Surgery of the digestive system
29Transplantation
30Transplants & implants
31Xylose - urine
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titleComparison of enteral feeding and total parenteral nutrition after liver transplantation
authorWicks, C ; Routley, D ; Williams, R ; Somasundaram, S ; Bjarnason, I ; Potter, D ; Tan, K.C ; Menzies, I.S
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03-O-Methylglucose
1Abridged Index Medicus
2Adolescent
3Adult
4Anthropometry
5Biological and medical sciences
6Enteral feeding
7Enteral Nutrition - methods
8Evaluation
9Female
10Food and nutrition
11Humans
12Intestinal Absorption
13Liver
14Liver Transplantation
15Liver, biliary tract, pancreas, portal circulation, spleen
16Male
17Medical research
18Medical sciences
19Methylglucosides - urine
20Middle Aged
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24Parenteral feeding
25Parenteral Nutrition, Total - methods
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atitleComparison of enteral feeding and total parenteral nutrition after liver transplantation
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volume344
issue8926
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pages837-840
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abstractSummary Total parenteral nutrition is used for nutritional support in patients undergoing orthotopic liver transplantation but is associated with complications. We compared the efficacy and tolerability of early enteral feeding with total parenteral nutrition after liver transplantation. 24 patients were studied: 14 received enteral feeding and 10 total parenteral nutrition. A double-lumen enteral tube was used to deliver the feed directly into the jejunum with the second lumen of the tube being used for gastric aspiration. Enteral feeding was started post-operatively within 18 h, was well-tolerated, and of comparable efficacy to total parenteral nutrition. The median number of days for patients to start eating (4) and to achieve 70% of estimated requirements orally (5) did not differ significantly between the two groups. Mid-arm circumference, triceps skinfold thickness, and biceps skinfold thickness were, by comparison with pre-operative values, maintained on the tenth postoperative day in both groups. Early postoperative absorptive capacity, as assessed by a combined carbohydrate test, was reduced significantly in both groups but insufficiently to be of nutritional concern. Intestinal mucosal integrity, as assessed by an intestinal permeability test, was maintained throughout. We conclude that the practical aspects of enteral feeding after liver transplantation are surmountable and that enteral feeding is as effective at maintaining nutritional status as total parenteral nutrition, and has potential benefits in terms of reduced complications and costs.
copLondon
pubElsevier Ltd
pmid7916398
doi10.1016/S0140-6736(94)92824-X