Abstract
Parenteral nutrition is used to support life during a period of intestinal failure when nutrients cannot be absorbed through the gastro-intestinal tract. Hypertonic solutions of amino-acids and glucose, with added vitamins, electrolytes, and trace elements, are administered, together with isotonic fat emulsions, directly into the superior vena cava or right atrium of the heart.
Access to the central venous circulation is obtained by the insertion of a soft, silicone rubber catheter into a neck or arm vein. Life threatening metabolic disturbance, infection, and catheter-associated complications may occur in the absence of attention to detail.
To prevent sudden changes in fluid and electrolyte status, and blood glucose levels, a method of flow control must be selected which remains accurate when infusing fluids of varying density or when the patient is mobile. It is important that the method selected does not allow high pressures to develop in the soft intravenous catheter and can be managed safely in the intensive care unit, the general ward, or by the patient in his own home.
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