parenteral


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parenteral

 [pah-ren´ter-al]
by some route other than through the alimentary canal, such as by subcutaneous, intramuscular, intrasternal, or intravenous injection.
parenteral nutrition a technique for meeting a patient's nutritional needs by means of intravenous feedings; sometimes called hyperalimentation, even though it does not provide excessive amounts of nutrients. Nutrition by intravenous feeding may be either total parenteral nutrition or only supplemental.

Total parenteral nutrition provides all of the carbohydrates, proteins, fats, water, electrolytes, vitamins, and minerals needed for the building of tissue, expenditure of energy, and other physiologic activities. The procedure originated as an emergency life-saving technique following surgery for severe and massive trauma of the gastrointestinal tract but has now become a relatively common means of providing bowel rest and nutrition in a variety of conditions in spite of inherent risks. Although primarily used as a short-term temporary measure until either surgical or medical treatment corrects the gastrointestinal dysfunction, it has also been used with some success as a long-term therapy for selected patients on an outpatient basis.

Parenteral nutrition may be used in the following conditions: malnutrition from such acute and chronic inflammatory bowel diseases as regional ileitis (crohn's disease) and ulcerative colitis, partial or total obstruction of the gastrointestinal tract that cannot be relieved immediately by surgery, congenital anomalies in the newborn prior to surgery, massive burns that produce critical protein loss, and other disorders in which malnutrition is a threat to the life of the patient who cannot receive nutrients via the digestive tract.

The nutrient mix is tailored to the individual needs and tolerance of the patient. There is not complete agreement among the experts as to the ideal mix, especially of amino acids. The nutrient solutions usually are prepared in clean-air rooms in the pharmacy of a hospital under aseptic conditions to avoid contamination.

Administration of the nutrients is accomplished via a central venous catheter, usually inserted in the superior vena cava. The route of administration, constant rate of flow required, and potential patient sensitivity to the elements administered, all contribute to the potential complications of parenteral nutrition.

Of the many complications that may develop, the most common are febrile reactions arising from patient intolerance to the required rate of flow, reactions due to individual sensitivity to some of the elements in the nutrient mix, and infection from contamination of either the site of insertion of the catheter or the apparatus used to administer the nutrients. Other complications that may develop include phlebitis and thrombosis of the vena cava, electrolyte imbalance, hyperglycemia, cardiac overload, dehydration, metabolic acidosis, and mechanical trauma to the heart.
Patient Care. Principles of strict aseptic technique must be followed in the daily changing of dressings and in handling the nutrient solution and the administration equipment. The catheter through which the nutrients are administered should not be used for administration of medication, blood, or any other substance that may induce clotting in the vein.
Superior vena cava administration of parenteral nutrition through a subclavian venous line. From Lammon et al., 1996.

pa·ren·ter·al

(pă-ren'tĕr-ăl),
By some other means than through the gastrointestinal tract; refers particularly to the introduction of substances into an organism by intravenous, subcutaneous, intramuscular, or intramedullary injection.
[para- + G. enteron, intestine]

parenteral

(pă-rĕn′tər-əl)
adj.
1. Physiology Located outside the digestive tract.
2. Medicine Taken into the body or administered in a manner other than through the digestive tract, as by intravenous or intramuscular injection.

par·en′ter·al·ly adv.

parenteral

adjective Referring to a non-topical route of administration; by injection is parenteral

pa·ren·ter·al

(pă-ren'tĕr-ăl)
By some other means than through the gastrointestinal tract; referring particularly to the introduction of substances into an organism by intravenous, subcutaneous, intramuscular, or intramedullary injection.
[para- + G. enteron, intestine]

parenteral

Of drugs or nutrients, taken or given by any route other than by the alimentary canal. Parenteral routes include the intramuscular and the intravenous.

Parenteral

Not in or through the digestive system. Parenteral nutrition is given through the veins of the circulatory system, rather than through the digestive system.

pa·ren·ter·al

(pă-ren'tĕr-ăl)
By some other means than through the gastrointestinal tract; referring particularly to the introduction of substances into an organism by intravenous, subcutaneous, intramuscular, or intramedullary injection.
[para- + G. enteron, intestine]

Patient discussion about parenteral

Q. why is it that some women lack parental nutrition?

A. Do you mean breastfeeding? Some women have problem with their nipples, in rare cases the breast tissue isn't developed enough. Sometimes breast surgeries damage the milk ducts. Psychological factors also play a role.

More discussions about parenteral
References in periodicals archive ?
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Total parenteral nutrition has multiple indications.
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Ryan Hawkins: When one looks at the recent warning letters and/or listens to the FDA discuss their perspective(s), it is clear that the prevailing view is that either Restricted Access Barrier Systems (RABS) or Barrier Isolators are the standard for safely manufacturing parenteral products; those manufacturers that are using conventional aseptic processing lines, whether clinical or commercial scale, can certainly expect to beunder increased scrutiny.
Results: The result was a standard SPC for authorized anthroposophic medicinal products in parenteral dosage forms containing mistletoe, which allows minor adaptations with respect to the declaration, kind of manufacturing of the preparations (homeopathic manufactured - other anthroposophics) and the different preclinical data levels submitted by different MAH's.
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