A compatibility study of common additives in protein hydrolysate-dextrose solutions for parenteral hyperalimentation
The use of the alimentary route to supply essential nutrients, either by mouth or nasogastric tube, is by far the best. This route, however, requires an intact and functioning gastrointestinal tract which may be found in certain chronic intestinal diseases, malignant tumors, and cases of gastrointestinal obstruction. In there and certain other clinical situations, parenteral feeding is necessary to provide essential nutrients normally provided in the diet. The intravenous route of administration is generally recognized as the most effective means of systemic administration. Yet, considering the other routes used clinically, it is of relatively recent development. Parenteral therapy began in 1616 with the discovery of the circulatory system by the English physician William Harvey. In 1656, Sir Christopher Wren successfully gave intravenous injection to dogs. Later years saw experimentation with attempts at parenteral therapy, especially blood transfusions, with little or no succes. It was not until the early nineteenth century that Thomas Latta, in Scotland, used saline with great success to treat the intractable diarrhea of cholera. He is considered to be the first man to use intravenous injection in terms of relational therapy. On the basis of the data presented here, it appears that the major compatibility problem in protein hydrolysatedextrose solutions will be that of high concentrations of calcium and phosphate ion. The compatible concentration ranges for these electrolytes have been mapped in Table VI. If a precipitation of calcium phosphate is to occur, it will be manifested almost immediately after admixture of the components. It has been demonstrated that greater concentrations of these ions will be tolerated by Polynute if the calcium component is added last (see Table VIIL). The reason for this phenomenon remains unclear. The maximum compatible concentrations does not seem to be affected by the addition of the other drugs included in this work. Common additives such as vitamins, insulin, heparin, and magnesium have not been shown to produce physical incompatibilities, in usual therapeutic concentrations.
Parenteral feeding, Proteins in human nutrition, Nutrition Research, Medicine and Health Sciences, Pharmacy and Pharmaceutical Sciences
Networked Digital Library of Theses and Dissertations