Adverse metabolic consequences of total parenteral nutrition. 1985

G L Klein, and D Rivera

Recently described metabolic complications of total parenteral nutrition (TPN) are discussed. Included are descriptions of disorders affecting the hepatobiliary system and the musculoskeletal system. The effects of TPN on the hepatobiliary system include cholestatic hepatitis and cholelithiasis; the complications affecting the musculoskeletal system include acute polymyopathy and low-turnover, osteomalacic bone disease. With the exception of the acute polymyopathy, which is probably due to essential fatty acid deficiency, the other systemic disorders may have multiple etiologies. Also summarized are the relatively recent findings of iatrogenic micronutrient deficiencies, including chromium, selenium, and molybdenum. These trace element deficiencies appear to have multisystem manifestations. Recommendations for management are discussed.

UI MeSH Term Description Entries
D008659 Metabolic Diseases Generic term for diseases caused by an abnormal metabolic process. It can be congenital due to inherited enzyme abnormality (METABOLISM, INBORN ERRORS) or acquired due to disease of an endocrine organ or failure of a metabolically important organ such as the liver. (Stedman, 26th ed) Thesaurismosis,Diseases, Metabolic,Disease, Metabolic,Metabolic Disease,Thesaurismoses
D009135 Muscular Diseases Acquired, familial, and congenital disorders of SKELETAL MUSCLE and SMOOTH MUSCLE. Muscle Disorders,Myopathies,Myopathic Conditions,Muscle Disorder,Muscular Disease,Myopathic Condition,Myopathy
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D010289 Parenteral Nutrition, Total The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins. Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D001851 Bone Diseases, Metabolic Diseases that affect the METABOLIC PROCESSES of BONE TISSUE. Low Bone Density,Low Bone Mineral Density,Osteopenia,Metabolic Bone Diseases,Bone Density, Low,Bone Disease, Metabolic,Low Bone Densities,Metabolic Bone Disease,Osteopenias
D002769 Cholelithiasis Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS). Gallstone Disease,Cholelithiases,Gallstone Diseases
D002780 Cholestasis, Intrahepatic Impairment of bile flow due to injury to the HEPATOCYTES; BILE CANALICULI; or the intrahepatic bile ducts (BILE DUCTS, INTRAHEPATIC). Bile Duct Obstruction, Intrahepatic,Biliary Stasis, Intrahepatic,Intrahepatic Cholestasis,Biliary Stases, Intrahepatic,Cholestases, Intrahepatic,Intrahepatic Biliary Stases,Intrahepatic Biliary Stasis,Intrahepatic Cholestases
D005228 Fatty Acids, Essential Long chain organic acid molecules that must be obtained from the diet. Examples are LINOLEIC ACIDS and LINOLENIC ACIDS. Acids, Essential Fatty,Essential Fatty Acids
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000535 Aluminum A metallic element that has the atomic number 13, atomic symbol Al, and atomic weight 26.98. Aluminium,Aluminium-27,Aluminum-27,Aluminium 27,Aluminum 27

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