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November 1969

High Caloric Glucose-Nitrogen Infusions: Postoperative Management of Neonatal Infants

Author Affiliations

Los Angeles
From the departments of surgery (Drs. Kaplan, Mares, Brennan, and Hays) and medicine (Drs. Quintana, Strauss, and Huxtable), Childrens Hospital of Los Angeles, University of Southern California School of Medicine, Los Angeles.

Arch Surg. 1969;99(5):567-571. doi:10.1001/archsurg.1969.01340170019005

Prolonged infusions of concentrated glucose-nitrogen solutions through central venous catheters have been shown by Dudrick and Wilmore to promote and maintain positive nitrogen balance.1-4 These solutions may offer an important adjuvant to the postoperative management of surgical patients. The nutritional requirement of small infants is so critical that the use of this technique during even relatively short periods of gastrointestinal insufficiency may be justified. In many cases, it is difficult to predict at the onset how long such parenteral therapy will be required. This mode of therapy is potentially hazardous, if not carefully monitored, in neonatal infants because of the hypertonic nature of the solutions.5,6 This paper reports the use of this technique in seven neonatal infants receiving relatively short-term high caloric parenteral therapy.

Clinical Series  Seven neonatal infants weighing between 1,100 and 2,770 gm (2.42 and 5.95 lb), average weight of 2,260 gm (4.98 lb), received high

Dudrick S.J.; Wilmore, D.W.; and Vars, H.M.:  Long-term Total Parenteral Nutrition With Growth in Puppies and Positive Nitrogen Balance in Patients ,  Surg Forum 18:356-357 ( (Oct) ) 1967.
Dudrick, S.J., et al:  Long-term Total Parenteral Nutrition With Growth Development and Positive Nitrogen Balance ,  Surgery 64:131-142 ( (July) ) 1968.
Dudrick, S.J., and Wilmore, D.W.:  Long-term Parenteral Feedings ,  Hosp Prac 3:65-78 ( (Oct) ) 1968.
Wilmore, D.W., and Dudrick, S.J.:  Growth and Development of an Infant Receiving All Nutrients Exclusively by Vein ,  JAMA 203:140-144 ( (March 4) ) 1968.Crossref
Winters, R.W., et al:  The Mechanism of Acidosis Produced by Hyperosmotic Infusions ,  J Clin Invest 43:647-653 ( (April) ) 1964.Crossref
Sotos, J.F.; Dodge, P.R.; and Talbot, N.B.:  Studies in Experimental Hypertonicity: II. Hypertonicity of Body Fluids as a Cause of Acidosis ,  Pediatrics 30:180-193 ( (Aug) ) 1962.
Hinkley, M.E.:  Thoracic Duct Thrombosis With Fetal Chylothorax Caused by a Long Venous Catheter ,  New Eng J Med 280:95-96 ( (Jan) ) 1969.Crossref