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Diagram for Easy Determination of the Fat Emulsion Amount in Total Parenteral Nutrition

Other Title
경정맥 과영양요법시 적정량의 지방 수액 투여를 위한 도표의 고안
Authors
홍, 정; 김, 명욱
Citation
Taehan Oekwa Hakhoe, 56(4):461-467, 1999
Journal Title
Taehan Oekwa Hakhoe; 대한외과학회지
ISSN
1226-0053
Abstract
Total parenteral nutrition (TPN) is a well-established method for providing nutrition

in surgical patients. Fat emulsion is an important component of TPN not only as a

high-energy source but also as a source of essential fatty acids. However, the

recommended amount of lipid administration varies from author to author, and it is not

clearly shown in most formulae. The aim of this study was to make a table for an

adequate amount of fat emulsion with different mixtures of amino acids and dextrose

solution, all of which being within the normal range (100 : 1 ∼ 150 : 1) o( nonprotein

calories-nitrogen ratio (NCNR). The total nonprotein calories were calculated by

multiplication of the nitrogen (weight) and the NCNR of normal ranges. The difference

between the total nonprotein calories and the calories from the dextrose solution was the

energy from the lipid emulsion and was converted to the volume of 10% fat emulsion

solution (Y-axis). Dextrose solutions were already classified according to concentrations

(15%, 17.5%, 20%, 22.5% and 25%). The ratio of calories from the lipid emulsion to

those from the total nonprotein was calculated, and the values ranging from 20% to 60%

were selected as the recommended volume. The numbers on the X-axis were the

volumes of 8.5% amino-acid solution. Six oblique lines with different slopes could be

gotten from the different concentrations of the dextrose solution and represented NCNRs

of 100 : 1, 110 : 1, 120 : 1, 130 : 1, 140 : 1, and 150 : 1. The highest points for the six

oblique lines were 60% nonprotein calories, and the lowest points were 20% nonprotein

calories. The area between the upper imaginary line collecting all the highest points of

the six oblique lines and the lower imaginary line connecting all the lowest points of six

oblique lines was a complex of points providing the ideal NCNR and the ideal amount

of fat emulsion in various volumes of 8.5% amino-acid solution in certain concentrations

of dextrose solution. We conclude that such graphs can be used in a situation when

modification of the formula is required during TPN.
Keywords
Total parenteral nutritionNonprotein calories-nitrogen ratioLipid graphs
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
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