Why taper parenteral nutrition

Methods: To determine whether hormonal counterregulatory mechanisms prevent hypoglycemia, we studied 12 patients 10 with inflammatory bowel disease, of which 6 received dexamethasone after both abrupt and tapered discontinuation of TPN solution in a clinical research facility. Venous blood was drawn before reduction of TPN rate in the tapered group or 15 minutes before and at abrupt discontinuation in the abrupt group and every 15 minutes for 1.

Mean epinephrine, norepinephrine, insulin, glucagon, growth hormone, cortisol, symptom score, and vital signs were not statistically different between the two groups. Plasma cortisol determination: radioimmunoassay and competitive binding compared. Clin Chem ;—4. External and internal standards in the single isotope derivative radioenzymatic assay of plasma norepinephrine and epinephrine in normal humans and persons with diabetes or chronic renal failure.

J Lab Clin Med ;—9. Adaptation to increasing loads of total parenteral nutrition: metabolic, endocrine, and insulin receptor responses. Gastroenterology ;— Mechanisms of postprandial glucose counterregulation in man: physiologic roles of glucagon and epinephrine vis-a-vis insulin in the prevention of hypoglycemia late after glucose ingestion.

Download references. Louis, Missouri. Patti G. Eisenberg M. You can also search for this author in PubMed Google Scholar. Eisenberg, P. Abrupt discontinuation of cycled parenteral nutrition is safe. Dis Colon Rectum 38, — Download citation. Issue Date : September Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.

Skip to main content. Search SpringerLink Search. References 1. PubMed Google Scholar 2. Google Scholar 3. PubMed Google Scholar 4. Google Scholar 5. PubMed Google Scholar 6. There was no difference between the lowest blood glucose in the abrupt group in comparison with that of the tapered group No patient had a significant change in hypoglycemia questionnaire score. There was no significant difference in age, duration of TPN, steroid use, or enteral caloric intake between the two groups.

We conclude that there was no symptomatic hypoglycemia, and glucose profiles returned to a similar baseline level in those whose TPN was abruptly stopped when compared with those in the tapered group. These data demonstrate that patients receiving TPN can have parenteral nutrition abruptly stopped without the development of significant hypoglycemia.