What Is Intravenous Feeding?

In general, intravenous nutrition is the feeding of nutrient solution (mainly glucose) through peripheral veins. This method has been used for a long time and is easy to operate. However, it is not possible to input hypertonic solution from the peripheral vein (hypertonic fluid stimulates the vein and easily causes thrombophlebitis), so it cannot meet the nutritional needs of patients. Complete intravenous nutrition is the infusion of high-nutrition fluids (including amino acids, essential fatty acids, vitamins, electrolytes, and trace elements) through deep veins, which can meet the high nutritional needs of patients. This method was successfully applied clinically in 1962. However, this method requires certain equipment conditions, difficult operation technology, strict aseptic operation requirements, and easy to be complicated by infection and comorbidities, so it is necessary to strictly grasp the indications.

Intravenous nutrition

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The body cannot ingest through the gastrointestinal tract

In general, intravenous nutrition is the feeding of nutrient solution (mainly glucose) through peripheral veins. This method has been used for a long time and is easy to operate, but it is not possible to input hypertonic solution from peripheral veins (hypertonic fluid stimulates veins and easily causes thrombosis

The main indications are: (1) those who cannot feed through the gastrointestinal tract such as esophageal fistula,

The energy source of intravenous nutrition is mainly glucose solution, followed by maltose, fructose, sugar alcohol and so on. The research and application of emulsified fats provide high energy substances for intravenous nutrition. Emulsified fat is composed of vegetable oil, emulsifier, water and tonicity agent. Commonly used vegetable oils are cottonseed oil, soybean oil or safflower oil. The volume of emulsified fat is small, and it can supply a lot of heat energy.

The properties of intravenous nutrition fluids are different, and the ways of entering the veins are also different. If the intravenous nutrient solution is a hypertonic sugar solution, it can only be infused from a deep vein using a catheter. Because such a solution has a high concentration, infusion from a peripheral vein can easily cause thrombophlebitis. If the venous nutrient solution consists of sugars, emulsified fats and amino acids, it can be input from the surrounding veins.

Deep vein catheterization methods include subclavian vein subclavian puncture, subclavian vein supraclavicular puncture, and jugular vein incision and intubation. Because the high nutrient solution is a good medium for bacteria and mold, once it is contaminated, it can cause serious infections. Therefore, aseptic technique should be strictly implemented to reduce the complications of infection. A portion of each batch of nutrient solution should be reserved for bacterial culture. To prevent local infection, the catheter should be coated with antibiotic ointment through the skin and covered with sterile gauze. If local infection is found, the catheter should be removed immediately, and puncture on the opposite side if necessary.

Patients receiving intravenous nutrition should undergo necessary medical examinations. Measure body weight daily, accurately record the amount of fluid in and out, and often determine serum urea, electrolyte, and protein concentrations to detect disorders of electrolyte and acid-base balance and hypoproteinemia early. When applying fat-free hypertonic intravenous nutrition, blood glucose and urine glucose should be measured daily, and hyperglycemia and osmotic diuresis caused by it should be found in time. When long-term application of intravenous nutrition, liver function, serum phosphate, blood calcium and blood magnesium concentrations should also be measured regularly. In recent years, it has been confirmed that long-term complete intravenous nutrition can easily cause trace element deficiency, especially iron, zinc, chromium, and manganese deficiency. When applying hypertonic "glucose system" intravenous nutrition, dehydration and coma of hyperglycemia and hypertonic non-ketogenic disease should be avoided. If this symptom occurs, intravenous nutrition infusion should be stopped immediately and other fluids used.

The high nutrient solution should be dripped in at an even rate. If the rate is too fast, hyperglycemia, diabetes, osmotic diuresis, and dehydration may occur. If the speed is too slow, the superiority of the high nutrient solution cannot be exerted. Electric perfusion devices have been designed to maintain a constant rate of high nutrient solution infusion.