Parenteral nutrition, as a way to provide the body with important trace elements and vitamins

As you know, proper and adequate nutrition is an obligatory part of the treatment of many traumatic injuries and diseases, therefore, in case of inadequate or inability to eat the patient, parenteral nutrition is used. The term "parenteral nutrition" comes from the Greek "para" - about and "enteron" - the gut and denotes providing the human body with nutrients - nutritional ingredients past the gastrointestinal tract, in which their quality and quantity correspond to the natural diet.

Artificial nutrition (parenteral or enteral) is indicated for patients who have not received food for more than 7-10 days. Such food can be complete and partial. With complete parenteral nutrition, all nutrients are injected into the vascular bed, and patients do not even drink plain water. Partial parenteral nutrition involves the use of only basic nutrients, such as proteins and carbohydrates, when the nutrition through the mouth is insufficient, requiring supplementation.

The purpose of parenteral nutrition is to provide the body with energy resources, plastic materials, microelements, electrolytes and vitamins, restoration and correction of existing losses, maintenance of active protein mass.

Indications for the use of parenteral nutrition are pathological conditions and diseases in which there is an organic or functional inconsistency of the gastrointestinal tract. This pattern is most often observed with ischemia and intestinal obstruction. Parenteral nutrition is applied in the presence of mechanical obstructions in the various gastrointestinal tracts for passage of food: tumor formations, burn or postoperative narrowing of the esophagus, purulent-septic processes, as well as anorexia, severe inflammatory changes, coma, unconsciousness and tetanus.

There are three main groups of substances, with the use of which parenteral nutrition is possible. Preparations: glucose, triacylglycerin and amino acids. It is important that the solutions of these substances are combined so that both the plastic and energy needs of the organism are fully provided.

Glucose solutions are introduced into large central veins, they have a concentration of 10 to 70%. Glucose is not a sufficient source of energy to meet energy needs, so its concentrated solutions are used.

Amino acids for parenteral nutrition, or rather their solutions, contain equivalent amounts of amino acids (essential and non-essential), have a concentration of 3 to 10%, and are hyperosmolar.

Parenteral nutrition should be performed under the compulsory supervision of a physician who controls the balance of fluid, nutrients and minerals in the body. There is a risk of infection at the point of injection, and with prolonged use of parenteral nutrition, there is a risk of spreading the infection throughout the body. In addition, in the case of poor attachment of the needle, the solution can get into the surrounding tissue, rather than into the vein, and lead to the appearance of an abscess.

Return to normal diet in patients who have been parenterally fed for a long time should occur gradually, since the body needs time to adapt.

The nature and depth of the pathological changes that occur in the body determine the main contraindications to the use of certain drugs used for parenteral nutrition. Thus, with renal or hepatic insufficiency, the use of fat emulsions and amino acid mixtures is contraindicated, with edema of the brain, lipid nephrosis, acute myocardial infarction, signs of fat embolism - fat emulsions.