The recent article by Schloerb and Henning1 raises concerns about the understanding and formulation of total parenteral nutrition (TPN). Beyond the dismay caused to this reader by the fact that members of the nutritional support service from a major university hospital struggled to define a difference between glucose and dextrose (there is none) and considered the natural target for a survey on TPN prescriptions to be pharmacy directors and not physicians, the authors' apparent conclusion that the glucose concentration of TPN solutions determines the rate of glucose delivery to the patient is remarkably wrong. Glucose delivery is a function of glucose concentration and rate of infusion. The authors regrettably fail to understand this concept, stating, ". . . the glucose concentration should be limited to less than 4 mg/kg per minute." A concentration is not a rate of delivery.
Albina JE. Problems of Total Parenteral Nutrition. Arch Surg. 1998;133(6):679. doi:
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