Skip to main content
Log in

Complications of Long-Term Home Total Parenteral Nutrition

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

The purpose of this review is to describe the most common complications of home total parenteral nutrition, their identification, treatment and prevention. Data sources were manuscripts and abstracts published in the English literature since 1968. Studies were selected for summarization in this review on the basis of clinical relevance to the practicing clinician. Home total parenteral nutrition is a relatively safe, life-saving method for nutrient delivery in patients with compromised gastrointestinal function. However, numerous complications, with associated morbidity and mortality, involving the delivery system and the gastrointestinal, renal, and skeletal systems may develop. Catheter-related complications are often preventable and treatable when they occur, although renal and bone abnormalities have elusive etiologies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. Dudrick SJ, Wilmore DW, Vars HM, Rhoads JE: Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery 64:134–142, 1968

    Google Scholar 

  2. Howard L, Ament M, Fleming CR, Shike M, Steiger E: Current use and clinical outcome of home parenteral and enteral nutrition therapies in the United States. Gastroenterology 109:355–365, 1995

    Google Scholar 

  3. Messing B, Lemann M, Landais P, Gouttebel MC, Gerard-Boncompain M, Saudin F, Vangossum A, Beau P, Guedon C, Barnoud D, Beliah M, Joyeux H, Bouletreau P, Robert D, Matuchansky C, Levere X, Lerebours E, Carpentier Y, Rambaud JC: Prognosis of patients with nonmalignant chronic intestinal failure receiving long-term home parenteral nutrition. Gastroenterology 108:1005–1010, 1995

    Google Scholar 

  4. Buchman AL, Moukarzel A, Goodson B, Herzog F, Pollack P, Reyen L, Alvarez M, Ament ME, Gornbein J: Catheterrelated infections associated with home parenteral nutrition and predictive factors for the need for catheter removal in their treatment. JPEN 18:297–302, 1994

    Google Scholar 

  5. Buchman AL, Lee S, Miller J, Valdecantos A: Candida fungemia diagnosed from peripheral blood smear. JAMA 260:2926, 1988

    Google Scholar 

  6. Mermel LA, Maki DG: Detection of bacteremia in adults: Consequences of culturing an inadequate volume of blood. Ann Intern Med 119:270–272, 1993

    Google Scholar 

  7. Mosca R, Curtas S, Forbes B, Meguid MM: The benefits of isolated cultures in the management of suspected catheter sepsis.Surgery 102:718–723, 1987

    Google Scholar 

  8. Capdevilla JA, Planes AM, Palomar M, et al: Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis. Eur J Microbiol Infect Dis 11:403–407, 1992

    Google Scholar 

  9. Johnson PR, Decker MD, Edwards KM, Schaffer W, Wright PF: Frequency of Broviac catheter infections in pediatric oncology patients. J Infect Dis 154:570–578, 1986

    Google Scholar 

  10. Widmer AF: Management of catheter-related bacteremia and fungemia in patients on total parenteral nutrition. Nutrition 13:18S–25S, 1997

    Google Scholar 

  11. Wang EEL, Prober CG, Ford-Jones L, Gold R: The management of central intravenous catheter infections. Pediatr Infect Dis 3:110–113, 1984

    Google Scholar 

  12. Prince A, Heller B, Levy J, Heird WC. Management of fever in patients with central vein catheters. Pediatr Infect Dis 5:20–24, 1986

    Google Scholar 

  13. Rannen T, Ladefofed K, Tvede M, Lorentzen JE, Jarnum S: Catheter-related septicaemia in patients receiving home parenteral nutrition. Scand J Gastroenterol 21:455–460, 1986

    Google Scholar 

  14. Messing B, Peitra-Cohen S, Debure A, Beliah M, Bernier JJ: Antibiotic-lock technique: A new approach to optimal therapy for catheter-related sepsis in home-parenteral nutrition patients. JPEN 12:185–189, 1988

    Google Scholar 

  15. Benoit JL, Carandang G, Sitrin M, Arnow PM: Intraluminal antibiotic treatment of central venous catheter infections in patients receiving parenteral nutrition at home. Clin Infect Dis 21:1286–1288, 1995

    Google Scholar 

  16. Krzywda EA, Andris DA, Edmiston CE Jr, Quebbeman EJ: Treatment of Hickman catheter sepsis using antibiotic lock technique. Infect Control Hos Epidemiol 16:596–598, 1996

    Google Scholar 

  17. King DR, Komer M, Hoffman J, Ginn-Pease ME, Stanley ME, Powell D, Harmel RP Jr: Broviac catheter sepsis: The natural history of an iatrogenic infection. J Pediatr Surg 20:728–733, 1985

    Google Scholar 

  18. Lecciones JA, Lee JW, Navarro EE, Witebsky FG, Marshall D, Steinberg SM, Pizzo PA, Walsh TJ: Vascular catheterassociated fungemia in patients with cancer: Analysis of 155 episodes. Clin Infect Dis 14:875–883, 1992

    Google Scholar 

  19. Dato VM, Dajani AS: Candidemia in children with central venous catheters: Role of catheter removal and amphotericin B therapy. Pediatr Infect Dis J 9:309–314, 1990

    Google Scholar 

  20. Rex JH, Bennett JE, Sugar AM, Pappas PG, Serody J, Edwards JE, Washburn RG: Intravenous catheter exchange and duration of candidemia. Clin Infect Dis 21:994–996, 1995

    Google Scholar 

  21. Howard L, Claunch C, McDowell R, Timchalk M: Five years of experience in patients receiving home nutrition support with the implanted reservoir: A comparison with the external catheter. JPEN 13:478–483, 1989

    Google Scholar 

  22. Wurzel CL, Halom K, Feldman JG, Rubin LG: Infection rates of Broviac-Hickman catheters and implantable venous devices. AJDC 142:536–540, 1988

    Google Scholar 

  23. Savage AP, Picard M, Hopkins CC, Malt RA: Complications and survival of multilumen central venous catheters used for total parenteral nutrition. Br J Surg 80:1287–1290, 1993

    Google Scholar 

  24. McCarthy MC, Shives J, Robinson RJ, Broadie TA: Prospective evaluation of triple and single lumen catheters in total parenteral nutrition JPEN 11:259–262, 1987

    Google Scholar 

  25. Yeung C, May J, Hughes R: Infection rate for single v triple lumen subclavian catheters. Infect Control Hosp Epidemiol 9:154–158, 1988

    Google Scholar 

  26. Keohane PP, Attrill H, Northover J, Jones BJM, Cribb A, Frost P: Effect of catheter tunneling and a nutrition nurse on catheter sepsis during parenteral nutrition. Lancet 2:1388–1390, 1983

    Google Scholar 

  27. Danzig LE, Short LJ, Collins K, Mahoney M, Sepe S, Bland L, Jarvis WR: Bloodstream infections associated with a needleless intravenous infusion system in patients receiving home infusion therapy. JAMA 273:1862–1864, 1995

    Google Scholar 

  28. Ravigione MC, Battan R, Pablos-Mendez a, Aceves-Casillas P, Mullen M, Taranta A: Infections associated with Hickman catheters in patients with acquired immunodeficiency syndrome. Am J Med 86:80–786, 1989

    Google Scholar 

  29. O'Keefe SJD, Burnes JU, Thompson RL: Recurrent sepsis in home parenteral nutrition patients: An analysis of risk factors. JPEN 18:256–263, 1994

    Google Scholar 

  30. Maki DG, Band JD. A comparative study of poly antibiotic and iodophor ointments in prevention of vascular catheterrelated infections. Am J Med 70:739–744, 1981

    Google Scholar 

  31. Sitges-Serra A, Linears J, Garau J: Catheter sepsis: The clue is the hub. Surgery 97:355–357, 1985

    Google Scholar 

  32. Salzman MB, Rubin LG: Relevance of the catheter hub as a portal for microorganisms causing catheter-related bloodstream infections. Nutrition 13:15S–17S, 1997

    Google Scholar 

  33. Stotter AT, Ward H, Waterfield AH, Hilton J, Sim AJW: Junctional care: The key to prevention of catheter sepsis in intravenous feeding. JPEN 11:159–162, 1987

    Google Scholar 

  34. De Cicco M, Panarello G, Chiaradia V, Fracasso A, Veronesi A, Testa V, Santini G, Tesio F: Source and route of microbial colonization of parenteral nutrition catheters. Lancet 2:1258–1261, 1989

    Google Scholar 

  35. Segura M, Alia C, Valverde J, Franch G, Rodriguez JMT, Sitges-Serra A: Assessment of a new hub design and the semiquantitative catheter culture methods using an in vivo experimental model of catheter sepsis. J Clin Microbiol 28:2551–2554, 1990

    Google Scholar 

  36. Sitges-Serra A, Puig P. Linaires J, Perez JL, Farrero N, Jaurrieta E, Garau J: Hub colonization as the initial step in an outbreak of catheter-related sepsis due to coagulase-negative staphylococci during parenteral nutrition. JPEN 8:668–672, 1984

    Google Scholar 

  37. Brismar B, Jordahl L, Nystrom B, Pettersson N: Bacterial contamination of intravenous line side ports of different designs. Clin Nutr 6:31–33, 1987

    Google Scholar 

  38. Snydman DR, Murray SA, Kornfield EJ, Majka JA, Ellis CA: Total parenteral nutrition-related infections. Am J Med 73:695–699, 1982

    Google Scholar 

  39. Maki DG, Ringer M, Alvarado CJ: Prospective randomized trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters. Lancet 338:339–343

  40. Goulet O, Larchet M, Gaillard JL, Goulet V, Jan D, Revillon Y, Lortat-Jacob S, Descamps P, Ricour C: Catheter related sepsis during long-term parenteral nutrition in paediatric gastroenterology patients: A study of 185 consecutive central venous catheters. Clin Nutr 9:73–78, 1990

    Google Scholar 

  41. Buchman AL, Ament ME, Reyen L, Herzog F, Alvarez M, Rannen T, Ladefoged K, Hegnhoj J, Moller EH, Brunn B, Jarnum S: Catheter-related sepsis in long-term parenteral nutrition with Broviac catheters. An evaluation of different disinfectants. Clin Nutr 9:350, 1990 (letter)

    Google Scholar 

  42. Segura M, Alvarez-Lerma F, Tellado JM, Jimenez-Ferreres J, Oms L, Rello J, Baro T, Sanchez R, Morera A, Mariscal D, Marrugat J, Sitges-Serra A: A clinical trial on the prevention of catheter-related sepsis using a new hub model. Ann Surgery 223:363–369, 1996

    Google Scholar 

  43. Rannen T, Ladefoged K, Hegnhoj J, Moller EH, Brunn B, Jarnum S: Catheter-related sepsis in long-term parenteral nutrition with Broviac catheters. An evaluation of different disinfectants. Clin Nutr 9:131–136, 1990

    Google Scholar 

  44. Inoue Y, Nezu R, Matsuda H, Fujii M, Nakai S, Wasa M, Takagi Y, Okada A: Experimental study of hub contamination: Effect of a new connection device: The I system. JPEN 16:178–180, 1992

    Google Scholar 

  45. Rannen T, Ladefoged K, Hegnhoj J, Moller EH, Brunn B, Jarnum S: Catheter-related sepsis in long-term parenteral nutrition with Broviac catheters. An evaluation of different disinfectants. Clin Nutr 10:60, 1991

    Google Scholar 

  46. Halpin DP, O'Byrne P, McEntee G, Hennessy TPJ, Stephens RB: Effect of a Betadine connection shield on central venous catheter sepsis. Nutrition 7:33–34, 1991

    Google Scholar 

  47. Burnes J, Kelly D, O'Keefe S, Devine R: Evaluation of a subcutaneous antimicrobial cuff in the reduction of catheter related infection in patients receiving home parenteral nutrition. JPEN 22:S15, 1998 (abstract)

    Google Scholar 

  48. Stebbins J, O'Neill M, Steiger E: The effect of decreased catheter care on primary sepsis rate in central venous catheters (CVC) used in parenteral nutrition. JPEN 13:16S, 1989 (abstract)

    Google Scholar 

  49. Powell C, Regan C, Fabri PJ, Ruberg RL: Evaluation of opsite catheter dressings for parenteral nutrition, a prospective, randomized trial. JPEN 6:43–46, 1982

    Google Scholar 

  50. Anderson PT, Herlevsen P, Schaumburg H: A comparative study of 'Op-site 'and 'nobecutan gauze 'dressings for central venous line care. J Hosp Infect 7:161–168, 1986

    Google Scholar 

  51. Conly JM, Grieves K, Peters B: a prospective, randomized study comparing transparent and dry gauze dressings for central venous catheters. J Infect Dis 159:310–319, 1989

    Google Scholar 

  52. Hoffman KK, Weber DJ, Samsa GP, Rutala WA: Transparent polyurethane film as an intravenous catheter dressing. JAMA 267:2072–2076, 1992

    Google Scholar 

  53. Powell CR, Traetow MJ, Fabri PJ, et al: Op-site dressing study: a prospective randomized study evaluating povidoneiodine ointment and extension set changes with 7-day Op-site dressings applied to total parenteral nutrition subclavian sites. JPEN 9:443–446, 1985

    Google Scholar 

  54. Hashal VL, Jr, Ause RG, Hoskins PA: Fibrin sleeve formation on indwelling subclavian central venous catheters. Arch Surg 102:353–358, 1971

    Google Scholar 

  55. Cassidy FP, Zajko AB, Bron KM, Reilly JJ, Peitzman AB, Steel DL: Noninfectious complications of long-term central venous catheters: Radiologic evaluation and management. Am J Radiol 149:671–675, 1987

    Google Scholar 

  56. Burt ME, Dunnick NR, Drudy AG, Maher MM, Brennan MF: Prospective evaluation of subclavian vein thrombosis during total parenteral nutrition by contrast venography. Clin Res 20:264A, 1981 (abstract)

    Google Scholar 

  57. Bozzetti F, Scarpa D, Terno G, Scotti A, Ammatuna M, Bonalumi MG, Ceglia E: Subclavian venous thrombosis due to indwelling catheters: A prospective study on 52 patients. JPEN 7:560–562, 1983

    Google Scholar 

  58. Fabri PJ, Mirtalo JM, Ruberg RL, Kudsk KA, Denning DA, Ellison C, Schaffer P: Incidence and prevention of thrombosis of the subclavian vein during total parenteral nutrition. Surg Gynecol Obstet 155:238–240, 1982

    Google Scholar 

  59. Buchman AL, Misra S, Moukarzel A, Ament ME: Catheter thrombosis and superior/inferior vena cava syndrome are rare complications of long term parenteral nutrition. Clin Nutr 13:356–360, 1994

    Google Scholar 

  60. Beers TR, Burnes J, Fleming CR: Superior vena caval ob-struction in patients with gut failure receiving home parenteral nutrition. JPEN 14:474–479, 1990

    Google Scholar 

  61. Schmidt-Sommerfeld E, Snyder G, Rossi TM, Lebenthal E: Catheter-related complications in 35 children and adolescents with gastrointestinal disease on home parenteral nutrition. JPEN 14:148–151, 1990

    Google Scholar 

  62. McCulloch I, Pennington CR: Intracardiac thrombus complicating prolonged parenteral nutrition in an adult.JPEN 13:557–559, 1989

    Google Scholar 

  63. Chamsi-Pasha H, Irving MH: Right atrial thrombus, a complication of total parenteral nutrition in an adult. Br Med J 295:308, 1987

    Google Scholar 

  64. Dollery CM, Sullivan ID, Bauraind O, Bull C, Mila PJ: Thrombosis and embolism in long-term central venous access for parenteral nutrition. Lancet 344:1043–1045, 1994

    Google Scholar 

  65. Mailloux RJ, DeLegge MH, Kirby DF: Pulmonary embolism as a complication of long-term total parenteral nutrition. JPEN 17:578–582, 1993

    Google Scholar 

  66. Leiby JM, Purcell H, DeMaria JJ, Kraut EH, Sagone AL, Metz EN: Pulmonary embolism a result of Hickman catheterrelated thrombosis. Am J Med 86:228–231, 1989

    Google Scholar 

  67. Bern MM, Bothe a, Bistrian BR, Champagne CD, Keane MS, Blackburn GL: Prophylaxis against central venous vein thrombosis with low dose warfarin. Surgery 99:216–221, 1986

    Google Scholar 

  68. Bern MM, Lokich JJ, Wallach SR, Bothe A Jr, Benotti PN, Arkin CF, Greco FA, Huberman M, Moore C: Very low dose warfarin can prevent thrombosis in central venous catheters. Ann Intern Med 112:423–428, 1990

    Google Scholar 

  69. Wessler T, Gittel SN, Bank H, Martinowitz U, Stephenson RC: An assay of the antithrombotic action of warfarin. Its correlation with the inhibition of stasis thrombosis in rabbits. Thromb Haemost 40:486–496, 1978

    Google Scholar 

  70. Bertina RM, Westhoek-Kuipers MEJ, Alderkamp GHJ: The inhibitor of prothrombin conversion in plasma of patients on oral anticoagulant treatment. Thromb Haemost 45:237–241, 1981

    Google Scholar 

  71. Gittel SN, Wessler S: Dose-dependent antithrombotic effect of warfarin in rabbits. Blood 61:435–438, 1983

    Google Scholar 

  72. Gould JR, Carloss HW, Skinner WL: Groshong catheterassociated subclavian thrombosis. Am J Med 95:419–423, 1993

    Google Scholar 

  73. Veerabagu MP, Tuttle-Newhall J, Maliakkal R, Champagne C, Mascioli EA: Warfarin and reduced central venous thrombosis in home total parenteral nutrition patients. Nutrition 11:142–144, 1995

    Google Scholar 

  74. Asherson RA, Cervera R: 'Primary, “secondary, 'and other variants of the antiphospholipid syndrome. Lupus 3:293–298, 1994

    Google Scholar 

  75. Lutomski DM, Palascak JE, Bower RH: Warfarin resistance associated with intravenous lipid administration. JPEN 11:316–318, 1987

    Google Scholar 

  76. Kumar A, Abell TL, Voeller G, Werkman R, Smalley R, Duncan U, Dugdale M, Taylor J: Is thrombosis of central venous access in idiopathic upper GI dysmotility related to the presence of circulating auto-antibodies? Gastroenterology 108:A734, 1995 (abstract)

    Google Scholar 

  77. Griffith GC, Nichols G, Asher JD, Flanaghan B: Heparin osteoporosis. JAMA 193:85–88, 1965

    Google Scholar 

  78. Den Heijer M, Blom HJ, Gerrits WBJ, Rosendaal FR, Haak HL, Wjermans PW, Bos GMJ: Is hyperhomocysteinaemia a risk factor for recurrent venous thrombosis? Lancet 345:882–885, 1995

    Google Scholar 

  79. Johnson OL, Washington C, Davis SS, Schaupp K: The destabilization of parenteral feeding emulsions by heparin. Int J Pharm 53:237–240, 1989

    Google Scholar 

  80. High KA: Antithrombin III, protein C, and protein S. Arch Pathol Lab Med 112:28–36, 1988

    Google Scholar 

  81. Buchman AL: Handbook of Nutritional Support. Philadelphia, Williams and Wilkins, 1997 pp 46–47

    Google Scholar 

  82. Aderka D, Brown A, Zelikovski A, Pinkhas J: Idiopathic deep vein thrombosis in an apparently healthy patient as a premonitory sign of occult cancer. Cancer 57:1846–1849, 1986

    Google Scholar 

  83. Moreno JM, Valero MA, Gomis P, Leon-Sanz M: Central venous catheter occlusion in home parenteral nutrition patients. Clin Nutr 17:35–36, 1998 (letter)

    Google Scholar 

  84. Glynn MFX, Langer B, Jeejeebhoy KN: Therapy for thrombotic occlusion of long-term intravenous alimentation catheters. JPEN 4:387–390, 1980

    Google Scholar 

  85. Haire WD, Lieberman RP: Thrombosed central venous catheters: restoring function with 6-hour urokinase infusion after failure of bolus urokinase.JPEN 16:129–132, 1992

    Google Scholar 

  86. Atkinson JB, Bagnall HA, Gomperts E: Investigational use of tissue plasminogen activator (t-PA) for occluded central venous catheters. JPEN 14:310–311, 1990

    Google Scholar 

  87. Stephens LC, Haire WD, Kotulak GD: Are clinical signs accurate indicators of the cause of central venous catheter occlusion? JPEN 19:75–79, 1995

    Google Scholar 

  88. Pithie AD, Pennington CR: The incidence, aetiology and management of central venous catheter thrombosis during parenteral nutrition. Clin Nutr 6:151–153, 1987

    Google Scholar 

  89. Messing B, Landais P, Goldfarb B, Irving M: Complications and management of implanted venous access catheters. J Clin Onc 3:710–717, 1985

    Google Scholar 

  90. O'Hanrahan T, Irving MH: The role of home parenteral nutrition in the management of intestinal failure-report of 400 cases. Clin Nutr 11:331–336, 1992

    Google Scholar 

  91. Lokich JJ, Bothe A Jr, Benotti P, Moore C: Complications and management of implanted venous access catheters. J Clin Oncol 3:710–717, 1985

    Google Scholar 

  92. Johnson RL, Lieberman RP, Kaplan PA, Haire WD: Silicone rubber catheter venography using standard angiographic techniques. Cardiovasc Interventional Radiol 11:45–49, 1988

    Google Scholar 

  93. Cassidy FP, Zajiko AB, Bron KM, Reilly JJ, Peitzman AB, Stead DL: Noninfectious complications of long-term central venous catheters: radiologic evaluation and management. AJR 149:671–675, 1987

    Google Scholar 

  94. Breaux CW, Duke D, Georgeson KE, Mestre JR: Calcium phosphate crystal occlusion of central venous catheters used for total parenteral nutrition in infants and children: prevention and treatment. J Pediatr Surg 22:829–832, 1987

    Google Scholar 

  95. Shulman RJ, Reed T, Pitre D, Laine L: Use of hydrochloric acid to clear obstructed central venous catheters. JPEN 12:509–510, 1988

    Google Scholar 

  96. Pennington CR, Pithie AD: Ethanol lock in the management of catheter occlusion. JPEN 11:507–508, 1987

    Google Scholar 

  97. Werlin SL, Lausten T, Jessen S, Toy L, Norton a, Dallman L, Bender J, Sabilan L, Rutkowski D: Treatment of central venous catheter occlusions with ethanol and hydrochloric acid. JPEN 19:416–418, 1995

    Google Scholar 

  98. Sando K, Fujii M, Tanaka K, Chen K, Yoshida H, Iiboshi Y, Nezu R, Konishi K, Takagi Y, Okada A: Lock method using sodium hydroxide solution to clear occluded central venous access devices. Clin Nutr 16:185–188, 1997

    Google Scholar 

  99. Johnston DA, Walker K, Richards J, Pennington CR: Ethanol flush for the prevention of catheter occulsion. Clin Nutr 11:97–100, 1992

    Google Scholar 

  100. Beau P, Matchuchansky C: Lipid delivery and catheter obstruction during cyclic total parenteral nutrition. Lancet 2:1095–1096, 1987

    Google Scholar 

  101. Messing B, Beiiah M, Giarard-Papau F, LeLeve D, Bernier JJ: Technical hazards of using nutritive mixes in bags for cyclic parenteral nutrition in 48 gastroenterological patients. Gut 23:297–303, 1982

    Google Scholar 

  102. Buchman AL, Moukarzel A, Ament ME, Gornbein J, Goodson B, Carlson C, Hawkins RA: Serious renal impairment is associated with long-term parenteral nutrition. JPEN 17:438–444, 1993

    Google Scholar 

  103. Moukarzel AA, Ament ME, Buchman AL, Dahlstrom KA, Vargas J: Renal function of children receiving long-term parenteral nutrition. J Pediatr 119:864–868, 1991

    Google Scholar 

  104. Graf H, Stummuoli HK, Luger A, Prager R: Effect of amino acid infusion on glomerular filtration rate. N Engl J Med 308:159–160, 1983 (letter)

    Google Scholar 

  105. Cochran ST, Pagani JJ, Barbaric ZL: Nephromegaly in hyperalimentation. Radiology 130:603–606, 1979

    Google Scholar 

  106. Moukarzel A, Song MK, Buchman AL, Vargas J, Guss W, McDiarmid S, Reyen L, Ament ME: Excessive chromium intake in children receiving total parenteral nutrition. Lancet 339:385–388, 1992

    Google Scholar 

  107. Buchman AL, Moukarzel A, Ament ME: The role of chromium and cadmium toxicity in TPN-induced nephropathy. J Clin Nutr Gastroenterol 7:39–41, 1992

    Google Scholar 

  108. Buchman AL, Moukarzel AA, Ament ME: Excessive urinary oxalate excretion occurs in long-term TPN patients both with and without ileostomies. J Am Coll Nutr 14:24–28, 1995

    Google Scholar 

  109. Rockwell G, Nelson B, Campfield T, McCool D, Hamilton S, Uden P: Oxalogenesis in neonatal nutrition solutions. JPEN 21:S8, 1997 (abstract)

    Google Scholar 

  110. Casaubon PR, Dahlstrom KA, Vargas J, Hawkins R, Mogard M, Ament ME: Intravenous fat emulsion (Intralipid) delays gastric emptying, but does not cause gastroesophageal reflux in healthy volunteers. JPEN 13:246–248, 1989

    Google Scholar 

  111. MacGregor IL, Wiley ZD, Lavigne ME, Way LW: Slowed rate of gastric emptying of solid food in man by high caloric parenteral nutrition. Am J Surg 138:652–654, 1979

    Google Scholar 

  112. Kotler DP, Levine GM: Reversible gastric and pancreatic hyposecretion after long-term total parenteral nutrition. N Engl J Med 300:241–242, 1979

    Google Scholar 

  113. Buchman AL, Moukarzel AA, Bhuta S, Belle M, Ament ME, Eckhert C, Holander D, Gornbein J, Kopple J, Vijayaroghavan SR: Parenteral nutrition is associated with intestinal morphologic and functional changes in humans. JPEN 19:453–460, 1995

    Google Scholar 

  114. Guedon C, Schmitz, Lerebours E, Metayer J, Audran E, Hemet J, Colin R: Decreased brush border hydrolase activities without gross morphologic changes in human intestinal mucosa after prolonged total parenteral nutrition in adults. Gastroenterology 90:373–378, 1986

    Google Scholar 

  115. Van der Hulst RRWJ, van Kreel BK, yon Meyenfeldt MF, Brummer RJM, Arends JW, Deutz NEP, Soeters PB: Glutamine and the preservation of gut integrity. Lancet 341:1363–1365, 1993

    Google Scholar 

  116. Sedman PC, MacFie J, Palmer MD, Mitchell CJ, Sagar PM: Preoperative total parenteral nutrition is not associated with mucosal atrophy or bacterial translocation in humans. Br J Surg 82:1663–1667, 1995

    Google Scholar 

  117. Knudsen KB, Bradley EM, Lecocq FR, Bellamy HM, Welsh JD: Effect of fasting and refeeding on the histology and disaccharidase activity of the human intestine. Gastroenterology 55:46–51, 1968

    Google Scholar 

  118. Adibi SA, Allen ER: Impaired jejunal absorption rates of essential amino acids induced by either dietary, caloric or protein deprivation in man. Gastroenterology 59:404–413, 1970

    Google Scholar 

  119. Tompkins, RK, Waisman J, Watt CMH, Corlin R, Keith R: Absence of mucosal atrophy in human small intestine after prolonged isolation. Gastroenterology 73:1406–1409, 1977

    Google Scholar 

  120. Buchman AL, Meztecky J, Moukarzel AA, Ament ME: Intestinal immune function is unaffected by parenteral nutrition in man. JACN 14:656–661, 1995

    Google Scholar 

  121. Van der Hulst RRWJ, yon Meyenfeldt MF, Tiebosch A, Buurman WA, Soeters PB: Glutamine and intestinal immune cells in humans. JPEN 21:310–315, 1997

    Google Scholar 

  122. Shike M, Harrison JE, Sturtridge WC, Tam CS, Bobechko PE, Jones G, Murray TM, Jeejeebhoy KN: Metabolic bone disease in patients receiving long-term total parenteral nutrition. Ann Intern Med 92:343–350, 1980

    Google Scholar 

  123. Klein GL, Ament ME, Bluestone R, Norman AW, Targoff CM, Sherrard DJ, Young JH, Coburn JW: Bone disease associated with total parenteral nutrition. Lancet 2:1041–1044, 1980

    Google Scholar 

  124. Klein GL, Horst RL, Norman AW, Ament ME, Slatopolsky E, Coburn JW: Reduced serum levels of 1a,25-dihydroxyvitamin D during long-term total parenteral nutrition. Ann Intern Med 94:638–643, 1981

    Google Scholar 

  125. Bengoa JM, Sitrin MD, Wood RJ, Rosenberg IH: Amino acid-induced hypercalciuria in patients on total parenteral nutrition. Am J Clin Nutr 38:264–269, 1983

    Google Scholar 

  126. Wood RJ, Bengoa JM, Sitrin MD, Rosenberg IH: Calciuretic effect of cyclic versus continuous total parenteral nutrition. Am J Clin Nutr 41:614–619, 1985

    Google Scholar 

  127. DeFonzo RA, Cooke CR, Andes R, Faloona GR, Davis PJ: The effect of insulin on renal handling of sodium, potassium, calcium, and phosphate in man. J Clin Invest 55:845–855, 1975

    Google Scholar 

  128. Wood RJ, Sitrin MD, Cusson GJ, Rosenberg IH: Reduction of total parenteral nutrition-induced urinary calcium loss by increasing the phosphorus in the total parenteral nutrition prescription. JPEN 10:188–190, 1986

    Google Scholar 

  129. Rudman D, Milliken WJ, Richardson TJ, Bixler TJ II, Stackhouse J, McGarrity WC: Elemental balances during intravenous hyperalimentation of underweight of underweight adult subjects. J Clin Invest 55:94–104, 1974

    Google Scholar 

  130. Karton MA, Rettmer R, Lipkin EW, Ott SM, Chait A: D-Lactate and metabolic bone disease in patients receiving long-term parenteral nutrition. JPEN 13:132–135, 1989

    Google Scholar 

  131. Lemann J Jr, Litzow JR, Lennon EJ: The effects of chronic acid loads in normal man: Further evidence for the participation of bone mineral in the defense against chronic metabolic acidosis. J Clin Invest 45:1608–1614, 1966

    Google Scholar 

  132. Lemann J Jr, Litzow JR, Lennon EJ: Studies of the mechanism by which chronic metabolic acidosis augments urinary calcium excretion in man. J Clin Invest 46:1318–1328, 1967

    Google Scholar 

  133. Cunningham J, Fraher LJ, Clemens TL, Revell PA, Papapoulos SE: Chronic acidosis with metabolic bone disease. Am J Med 73:199–204, 1982

    Google Scholar 

  134. Saitta JC, Lipkin EW, Howard GA: Acetate inhibition of chick bone cell proliferation and bone growth in vitro. J Bone Min Res 4:379–386, 1989

    Google Scholar 

  135. Berkelhammer CH, Wood RJ, Sitrin MD: Acetate and hypercalciuria during total parenteral nutrition. Am J Clin Nutr 48:1482–1489, 1988

    Google Scholar 

  136. Klein GL, Alfrey AC, Miller NL, Sherrard DJ, Hazlet TK, Ament ME, Coburn JW: Aluminum loading during total parenteral nutrition. Am J Clin Nutr 35:1425–1429, 1982

    Google Scholar 

  137. Ott SM, Maloney NA, Klein GL, Alfrey AC, Ament ME, Coburn JW, Sherrard DJ: Aluminum is associated with low bone formation in patients receiving chronic parenteral nutrition. Ann Intern Med 98:910–914, 1983

    Google Scholar 

  138. Vargas JH, Klein GL, Ament ME, Ott SM, Sherrard DJ, Horst RL, Berquist WE, Alfrey AC, Slatopolsky E, Coburn JW: Metabolic bone disease of parenteral nutrition: course after changing from casein to amino acids in parenteral solutions with reduced aluminum content. Am J Clin Nutr 48:1070–1078, 1988

    Google Scholar 

  139. Lipkin EW, Ott SM, Klein GL: Heterogeneity of bone histology in parenteral nutrition patients. Am J Clin Nutr 46:673–680, 1987

    Google Scholar 

  140. Koo W, Kaplan LA, Horn J, Tsang RC, Steichen JJ: Aluminum in parenteral nutrition solution sources and possible alternatives. JPEN 10:591–595, 1986

    Google Scholar 

  141. Heyman MB, Klein GL, Wong a, Recker RR, Tyrell JB, Alfrey AC, Sherrard D.J, Hohn DC: Aluminum does not accumulate in teenagers and adults on prolonged parenteral nutrition containing free amino acids. JPEN 10:86–87, 1986

    Google Scholar 

  142. Saitta JC, Ott SM, Sherrard DJ, Walden CE, Lipkin EW: Metabolic bone disease in adults receiving long-term parenteral nutrition: longitudinal study with regional densitometry and bone biopsy. JPEN 17:214–219, 1993

    Google Scholar 

  143. Moukarzel A, Ament ME, Vargas J, McDiarmid S, Reyen L, Najm I, Guss W: Non aluminum dependent osteopathy in children on long term parenteral nutrition. Am J Clin Nutr 51:520S, 1990 (abstract)

    Google Scholar 

  144. Foldes J, Rimon B, Muggia-Sullam M, Gimmon Z, Leichter I, Steinberg R, Menczel J, Freund HR: Progressive bone loss during long-term home total parenteral nutrition. JPEN 14:139–142, 1990

    Google Scholar 

  145. Staun M, Yjellesen L, Thale M, Rannem T, Schaadt O, Jarnum S: Bone mineral content in patients on home parenteral nutrition. Clin Nutr 13:351–355, 1994

    Google Scholar 

  146. Moukarzel AA, Buchman AL, Vargas J, Baron HI, Ament ME: Is fluoride deficiency related to the bone disease of parenteral nutrition? Gastroenterology 102:A568, 1992 (abstract)

    Google Scholar 

  147. Shike M, Shils ME, Heller A, Alcock N, Vigorita V, Brockman R, Holick MF, Lane J, Flombaum C: Bone disease in prolonged parenteral nutrition: osteopenia without mineralization defect. Am J Clin Nutr 44:89–98, 1986

    Google Scholar 

  148. Podenphant J, Johansen JS, Thomsen K, Riis BJ, Leth A, Christiansen C: Bone turnover in spinal osteoporosis. J Bone Min Res 2:497–503, 1987

    Google Scholar 

  149. Lipkin EW, Ott SM, Klein GL, Deftos LJ: Serum markers of bone formation in parenteral nutrition patients. Calcif Tiss Int 47:75–81, 1990

    Google Scholar 

  150. Verhage AH, Cheong WK, Allard JP, Jeejeebhoy KN: Increase in lumbar spine bone mineral content in patients on long-term parenteral nutrition without vitamin D supplementation. JPEN 19:431–436, 1995

    Google Scholar 

  151. Penden VH, Witzeleben CL, Skelton MA: Total parenteral nutrition. J Pediatr 78:180–181, 1971

    Google Scholar 

  152. Cavicchi M, Crenn P, Beau P, Degott C, Boutron MC, Messing B: Severe liver complications associated with long-term parenteral nutrition are dependent on lipid parenteral input. Clin Nutr 17:S18, 1998 (abstract)

    Google Scholar 

  153. Chan S, Mc Cowen KC, Bistrian BR, Thibault A, Keane-Ellison M, Forse RA, Babineau T, Burke P: Incidence, prognosis, and etiology of end-stage liver disease in patients receiving home parenteral nutrition. Surgery 126:28–34, 1999

    Google Scholar 

  154. Sax HC, Talamini MA, Brackett K, Fischer JE: Hepatic steatosis in parenteral nutrition: Failure of fatty infiltration to correlate with abnormal serum hepatic enzyme levels. Surgery 100:697–704, 1986

    Google Scholar 

  155. Grant JP, Cox CE, Kleinman LM, Mahrer MM, Pittman MA, Tangrea JA, Brown JH, Gross E, Beazley RM, Jones RS: Serum hepatic enzyme and bilirubin elevations during parenteral nutrition. Surg Gynecol Obstet 145:573–580, 1977

    Google Scholar 

  156. Robertson JFR, Garden OJ, Shenkin A: Intravenous nutrition and hepatic dysfunction. JPEN 10:172–176, 1986

    Google Scholar 

  157. Host WR, Serlin O, Rush BF: Hyperalimentation in cirrhotic patients. Am J Surg 123:57–62, 1972

    Google Scholar 

  158. Baker AL, Rosenberg IH: Hepatic complications of total parenteral nutrition. Am J Med 82:489–497, 1987

    Google Scholar 

  159. Sheldon GF, Peterson SR, Sander R: Hepatic dysfunction during hyperalimentation. Arch Surg 113:504–508, 1978

    Google Scholar 

  160. Buchman AL, Dubin M, Jenden D, Moukarzel A, Roch MH, Rice K, Gornbein J, Ament ME, Eckhert C: Lecithin increases plasma free choline and decreases hepatic steatosis in long-term total parenteral nutrition patients. Gastroenterology 102:1363–1370, 1992

    Google Scholar 

  161. Chambier C, Lemann M, Vahedi K, Boncompain-Gerard M, Robert D, Bouletreau P, Messing B: Chronic cholestasis in patients supported by prolonged parenteral nutrition. JPEN 22:S16, 1998 (abstract)

    Google Scholar 

  162. Stanko RT, Nathan G, Mendelow H, Adibi SA: Development of hepatic cholestasis and fibrosis in patients with massive loss of intestine supported by prolonged parenteral nutrition. Gastroenterology 92:197–208, 1987

    Google Scholar 

  163. Cavicchi M, Crenn P, Beau P, Degott C, Boutron MC, Messing B: Severe liver complications associated with long-term parenteal nutrition are dependent on lipid parenteral input. Gastroenterology 112:A864, 1997 (abstract)

    Google Scholar 

  164. Craig RM, Neumann T, Jeejeebhoy KN, Yokoo H: Severe hepatocellular reaction resembling alcoholic hepatitis with cirrhosis after massive small bowel resection and prolonged total parenteral nutrition. Gastroenterology 79:131–137, 1980

    Google Scholar 

  165. Rabeneck L, Freeman H, Owen D: Death due to TPN-related liver failure. Gastroenterology 86:1215,1984 (abstract)

    Google Scholar 

  166. Bowyer BA, Fleming CR, Ludwig J, Petz J, McGill DB: Does long-term home parenteral nutrition in adult patients cause chronic liver disease? JPEN 9:11–17, 1985

    Google Scholar 

  167. Powell EE, Cooksley WGE, Hanson R, Searle J, Halliday JW, Powel LW: The natural history of nonalcoholic steatohepatitis: A follow-up study of forty-two patients for up to 21 years. Hepatology 11:74–80, 1990

    Google Scholar 

  168. Lowry SF, Brennan MF: Abnormal liver function during parenteral nutrition: relation to infusion excess. J Surg Res 26:300–307, 1979

    Google Scholar 

  169. Meguid MM, Akahoshi MP, Jeffers S, Hayashi RJ, Hammond WG: Amelioration of metabolic complications of conven-tional total parenteral nutrition. Arch Surg 119:1294–1298, 1984

    Google Scholar 

  170. Langer B, McHattie JD, Zohrab WJ, Jeejeebhoy KN: Prolonged survival after complete bowel resection using intravenous alimentation at home. J Surg Res 15:226–233, 1973

    Google Scholar 

  171. McDonald ATJ, Philips MJ, Jeejeebhoy KN: Reversal of fatty liver by Intralipid in patients on total parenteral nutrition. Gastroenterology 64:885, 1973 (abstract)

    Google Scholar 

  172. Reif S, Tano M, Oliverio R, Young C, Rossi T: Total parenteral nutrition-induced steatosis: Reversal by parenteral lipid infusion. JPEN 15:102–104, 1991

    Google Scholar 

  173. Holman RT: The ratio of the trienoic:tetrenoic acid in tissue lipids as a measure of essential fatty acid requirements. J Nutr 70:405–410, 1960

    Google Scholar 

  174. Bowyer BA, Miles JM, Haymond MW, Fleming CR: LCarnitine therapy in home parenteral nutrition patients with abnormal liver tests and low plasma carnitine concentrations. Gastroenterology 94:434–438, 1988

    Google Scholar 

  175. Lave T, Lutz O, Frey A, Ehret C, Bach AC: Carnitine supplementation and fat emulsion clearance and utilization. Infusiontherapie 15:152–157, 1988

    Google Scholar 

  176. Buchman AL, Dubin MD, Moukarzel AA, Jenden DJ, Roch M, Rice K, Gornbein J, Ament ME: Choline deficiency: A cause of hepatic steatosis during parenteral nutrition that can be reversed with intravenous choline supplementation. Hepatology 22:1399–1404, 1995

    Google Scholar 

  177. Chawla RK, Wolf DC, Kutner MH, Bonkovsky HL: Choline may be an essential nutrient in malnourished patients with cirrhosis. Gastroenterology 97:1514–1520, 1989

    Google Scholar 

  178. Burt ME, Hanin I, Brennan MF: Choline deficiency associated with parenteral nutrition. Lancet 1:638–639, 1980

    Google Scholar 

  179. Buchman AL, Moukarzel A, Jenden DJ, Roch M, Rice K, Ament ME: Hepatic transaminase abnormalities are associated with low plasma free choline in patients receiving long term parenteral nutrition. Clin Nutr. 12:33–37, 1993

    Google Scholar 

  180. Yao Z, Vance DE: The active synthesis of phosphatidylcholine is required for very low density lipoprotein secretion from rat hepatocytes. J Biol Chem 263:2998–3004, 1988

    Google Scholar 

  181. Lombardi B, Ugazio G, Raick AN: Choline-deficiency-fatty liver: Relation of plasma phospholipids to liver triglycerides. Am J Physiol 210:31–36, 1968

    Google Scholar 

  182. Buchman AL, Sohel M, Dubin M, Jenden DJ, Roch M: Choline-supplemented TPN reverses hepatic morphologic abnormalities and liver test abnormalities in long-term home TPN patients: A placebo-controlled trial. Clin Nutr (in press) (abstract)

  183. Jobert A, Colomb V, Goulet O, Fournet JC, Lacaille F, Corriol O, Ricour C: Cholestasis associated with parenteral nutrition in children: role of lipid emulsions. Clin Nutr 16:S51, 1997 (abstract)

    Google Scholar 

  184. Vileisis RA, Sorensen K, Gonzalez-Crussi F, Hunt CE: Liver malignancy after parenteral nutrition. J Pediatr 100:88–90, 1982

    Google Scholar 

  185. Ghoshal AK, Farber E: The induction of liver cancer by dietary deficiency of choline and methionine without added carcinogens. Carcinogenesis 5:1367–1370, 1984

    Google Scholar 

  186. Yokoyama S, Sells MA, Reddy TV, Lombardi B: Hepatocarcinogenic and promoting action of a choline-devoid diet in the rat. Cancer Res 45:2834–2842, 1985

    Google Scholar 

  187. Fell JME, Reynolds AP, Meadows N, et al: Manganese toxicity in children receiving long-term parenteral nutrition. Lancet 347:1218–1221, 1996

    Google Scholar 

  188. Beath SV, Gopalan S, Booth IW: Manganese toxicity and parenteral nutrition. Lancet 347:1773–1774, 1996 (letter)

    Google Scholar 

  189. Clayton PT, Bowron A, Mills KA, Massoud A, Casteels M, Milla PJ: Phytosterolemia in children with parenteral nutrition-associated liver disease. Gastroenterology 105:1806–1813, 1993

    Google Scholar 

  190. Degott C, Messing B, Moreau D, Chazouilleres O, Paris R, Colambel JF, Lebrec D, Potet F, Feldman G, Benamou JP: Liver phospholipidosis induced by parenteral nutrition: histologic, histochemical, and ultrasound investigation. Gastroenterology 95:183–191, 1988

    Google Scholar 

  191. Gleghorn EE, Merritt RJ, Subramanian N, Ramos A: Phenobarbital does not prevent total parenteral nutrition-induced cholestasis in noninfected neonates. JPEN 10:282–283, 1986

    Google Scholar 

  192. Spurr SG, Grylack LJ, Mehta NR: Hyperalimentationassociated neonatal cholestasis: Effect of oral gentamicin. JPEN 13:633–636, 1989

    Google Scholar 

  193. Cocjin J, Vanderhal A, Sehgal S, Rosenthal P: Ursodeoxycholic acid therapy for total parenteral nutrition-associated cholestasis in the neonate. Gastroenterology 104:A615, 1993 (abstract)

    Google Scholar 

  194. Spagnuolo MI, Iorio R, Vegnente A, Guarino A: Ursodeoxycholic acid for treatment of cholestasis in children on longterm total parenteral nutrition: A pilot study. Gastroenterology 111:716–719, 1996

    Google Scholar 

  195. Lindor KD, Burnes J: Ursodeoxycholic acid for the treatment of home parenteral nutrition-associated cholestasis. Gastroenterology 101:250–253, 1991

    Google Scholar 

  196. Beau P, Labat-Labourdette J, Ingrand P, Beauchant M: Is ursodeoxycholic acid an effective therapy for total parenteral nutrition-related liver disease? J Hepatol 20:240–244, 1994

    Google Scholar 

  197. Teitelbaum DH, Han-Markey TH, Drongowski RA, Coran AG, Bayer B, Geiger JD, Uitvlugt N, Schork AM: Use of cholecystokinin to prevent the development of parenteral nutrition-associated cholestasis. JPEN 21:100–103, 1997

    Google Scholar 

  198. Roslyn JJ, Pitt HA, Mann LL, Ament ME, DenBesten L: Gallbladder disease in patients on long-term parenteral nutrition. Gastroenterology 84:148–154, 1983

    Google Scholar 

  199. Flati G, Flati D, Jonsson PE, Porowska B, Tuscano D, Amicucci G, Negro P, Carboni M: Role of cholesterol and calcium bilrubinate crystals in acute postoperative acalculous cholecystitis. Ital J Surg Sci 14:333–336, 1984

    Google Scholar 

  200. Deitch EA, Engel JM: Acute acalculous cholecystitis. Am J Surg 142:290–292, 1983

    Google Scholar 

  201. Gullick HD: Roetgenologic study of gallbladder following nonbiliary tract surgery. Ann Surg 151:403–408, 1960

    Google Scholar 

  202. Warner BW, Hamilton FN, Silberstein EB, Gaskill M, Teague D, Bowder RH, Fischer JE: The value of hepatobiliary scans in fasted patients receiving total parenteral nutrition. Surgery 102:595–601, 1987

    Google Scholar 

  203. Schuman WP, Gibbs P, Rudd TG, Mack LA: PIPIDA scintigraphy for cholecystitis: False positive in alcoholism and total parenteral nutrition. Surgery 102:595–601, 1987

    Google Scholar 

  204. Flancbaum L, Alden SM: Morphine cholescintigraphy. Surg Gynecol Obstet 171:227–232, 1990

    Google Scholar 

  205. Messing B, Bories C, Kunstlinger F, Bernier JJ: Does total parenteral nutrition induce gallbladder sludge formation and lithiasis? Gastroenterology 84:1012–1019, 1983

    Google Scholar 

  206. Messing B, Aprahamian M, Rautureau M, Baries C, Bisalli a, Stock-Damge S: Gallstone formation during total parenteral nutrition: a prospective study in man. Gastroenterology 86:1183, 1984 (abstract)

    Google Scholar 

  207. Roslyn JJ, Denbesten L, Pitt HA, Kuchenbecker S, Polarek JW: Effect of cholecystokinin on gallbladder stasis and cholesterol gallstone formation. J Surg Res 30:200–204, 1981

    Google Scholar 

  208. Mashako MNK, Cezard JP, Boige N, Chayvialle JA, Bernard C, Navarro J: The effect of artificial feeding on cholestasis, gallbladder sludge and lithiasis in infants: Correlation with plasma cholecystokinin levels. Clin Nutr 10:320–327, 1991

    Google Scholar 

  209. Allen B, Bernhoft R, Blanckaert N, Svanvik J, Filly R, Gooding G, Way L: Sludge is calcium bilirubinate associated with bile stasis. Am J Surg 141:51–56, 1981

    Google Scholar 

  210. Pitt HA, Berquist WE, Mann LL, Porter-Fink V, Fonkalsrud EW, Ament ME, DenBesten L: Parenteral nutrition induces calcium bilirubinate gallstones. Gastroenterology 84:1274, 1983 (abstract)

    Google Scholar 

  211. O'Brien CB, Berman JM, Fleming CR, Malet PF, Soloway RD: Total parenteral nutrition gallstones contain more calcium bilirubinate than sickle cell gallstones. Gastroenterology 90:1752, 1986 (abstract)

    Google Scholar 

  212. Stewart L, Smith L, Pellegrini CA, Matson RW, Way LW: Pigment gallstones form as a composite of bacterial microcolonies and pigment solids. Ann Surg 206:242–250, 1987

    Google Scholar 

  213. Doty JE, Pitt HA, Porter-Fink V, Denbesten L. Cholecystokinin prophylaxis of parenteral nutrition-induced gallbladder disease. Ann Surg 201:76–80, 1985

    Google Scholar 

  214. Sitzman JV, Pitt HA, Steinborn PA, Pasha ZR, Sanders RC: Cholecystokinin prevents parenteral nutrition induced biliary sludge in humans. Surg Gynecol Obstet 170:25–31, 1990

    Google Scholar 

  215. Apelgren KN, Willard DA, Vargish T: TPN alters gallbladder responsitivity to cholecystokinin. JPEN 12:11S, 1988 (abstract)

    Google Scholar 

  216. Dawes LG, Muldoon JP, Greiner MA, Bertolotti M: Cholecystokinin increases bile acid synthesis with total parenteral nutrition but does not prevent stone formation. J Surg Res 67:84–89, 1997

    Google Scholar 

  217. de Boer SY, Masclee AAM, Lam WF, Jansen JBMJ, Lamers CBHW: Intravenous amino acids stimulate gallbladder contraction. Gastroenterology 104:A358, 1993 (abstract)

    Google Scholar 

  218. Kalfarentzos F, Vagenas C, Michail A, et al: Gallbladder contraction after administration of intravenous amino acids and long-chain triacylglycerols in humans. Nutrition 7:347–349, 1991

    Google Scholar 

  219. Doty JE, Pitt HA, Porter-Fink V, Denbesten L: The effect of intravenous fat and total parenteral nutrition on biliary physiology. JPEN 8:263–268, 1984

    Google Scholar 

  220. Priori P, Lezzilli R, Panuccio D, Nardi R, Gullo L: Stimulation of gallbladder emptying by intravenous lipids. JPEN 21:350–352, 1997

    Google Scholar 

  221. Guedon C, Ducrotte P, Chayvialle JA, Lerebours E, Denis P, Colin R: Effect of intravenous and intraduodenal fat on jejunal motility and on plasma cholecystokinin in man. Dig Dis Sci 33:558–564, 1988

    Google Scholar 

  222. Broughton G, Fitzgibbons RJ Jr, Geiss RW, Adrian TE, Anthone G: IV chenodeoxycholate prevents calcium bilirubinate gallstones during total parenteral nutrition in the prairie dog. JPEN 20:187–193, 1996

    Google Scholar 

Download references

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Buchman, A.L. Complications of Long-Term Home Total Parenteral Nutrition. Dig Dis Sci 46, 1–18 (2001). https://doi.org/10.1023/A:1005628121546

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1005628121546

Navigation