Search PubMed⌕ Search

Biomedical subjects

J MacFie

Publications and source records attributed to J MacFie.

67 records · Page 4Linked to original sources
PubMed1986

Influence of intraperitoneal drains on subhepatic collections following cholecystectomy: a prospective clinical trial.

In this prospective randomized study, the influence of an intraperitoneal drain on the incidence and clinical significance of subhepatic collections occurring in patients after acute or elective cholecystectomy was assessed by ultrasound examination. A total of 112 patients entered the study, of whom 54 received a drain. There was no significant difference between the drainage and the non-drainage groups with respect to mean age or sex distribution, the number of patients in whom the gallbladder bed was formally closed (27 versus 21) nor in the number of acute cholecystectomies performed in either group (12 versus 13). Ultrasound detected 10 (18 per cent) collections in the drainage group and only one (1.8 per cent) in the non-drainage group (P less than 0.01, chi 2 test). None of the collections required any further treatment and no morbidity occurred that was directly attributable to the presence of the retained fluid. These results suggest that rather than preventing fluid collections, suction drains may predispose to the development of subhepatic collections after cholecystectomy.

Bile↗
PubMed1981

Effect of added insulin on body composition of gastroenterologic patients receiving intravenous nutrition--a controlled clinical trial.

The administration of insulin of hypercatabolic patients with burns or multiple fractures has been shown to be associated with increased nitrogen retention during intravenous nutrition (IVN) with solutions of amino acids and hypertonic dextrose. It is not known if gastroenterologic patients in whom the degree of stress is much less, show a similar response. In a controlled study of two comparable groups of 16 gastroenterologic patients on a surgical service who received IVN for 2 wk the changes in body weight, fat, water, protein, and potassium that occurred were measured. The control group received a nutrient solution of hypertonic glucose and amino acids (44.7 +/- 9.0 kcal/kg/day) and the comparative group (45.9 +/- 6.6 kcal/kg/day) in addition had 30 IU of soluble insulin added to each 1006 kcal of nutrient solution. Both groups of patients gained similar amounts of weight, fat, and water, and body protein was maintained to the same extent. Those patients receiving insulin demonstrated a gain of total body potassium (p less than 0.001). The results show that the routine administration of insulin is not indicated in this type of patient, provided that glucose intolerance is absent.

Adult↗
PubMedDate not supplied

Active metabolic expenditure of gastroenterological surgical patients receiving intravenous nutrition.

The active metabolic expenditure of 30 gastroenterological surgical patients was measured by performing an energy balance study over 14 days of intravenous nutrition. The mean value of active metabolic expenditure in preoperative patients (559 +/- 384 kcal/day) was significantly higher (p less than 0.02) than postoperative patients (245 +/- 325 kcal/day) but there was wide individual variation within both groups. Combinations of these results with values of resting metabolic expenditure obtained in the same patients suggest that very few uncomplicated surgical patients will ever require more than 2000 kcal/day to achieve a positive energy balance.

Adult↗
PubMedDate not supplied

Peripheral and central parenteral nutrition: a cost-comparison analysis.

The concept that total parenteral nutrition (TPN) has to be administered centrally is increasingly recognised to be mistaken: for most patients, peripheral parenteral nutrition provides satisfactory nutritional support. Use of the peripheral route avoids the risks of central venous cannulation--but is it more cost-effective? In a randomized clinical study we examined the costs of TPN in 51 patients who underwent a mean of 8 days of intravenous feeding and conclude that the use of peripheral parenteral nutrition may lead to cost savings.

Catheterization↗
PubMedDate not supplied

Continuous versus intermittent infusion of fat emulsions during total parenteral nutrition: clinical trial.

It is now generally accepted that fat emulsions are an efficient energy source during total parenteral nutrition (TPN). However, there is debate about how this fat should be prescribed. Some authorities prescribe fat as an intermittent infusion, alternating fat and carbohydrate, whereas others prefer a continuous infusion, giving fat simultaneously with carbohydrate. This 6-day crossover study examined the substrate-hormonal profiles of 10 patients in response to two isocaloric and isonitrogenous TPN regimens. In regimen A (intermittent), equicaloric volumes of 25% glucose and 10% Intralipid as energy sources were alternated every 12 h. During regimen B (continuous), the total nonprotein calories given each day was the same as in regimen A, but glucose and fat were infused simultaneously over every 24-h period. Amino acids were infused continuously throughout the study period in all patients. Blood samples were taken every 12 h. Wide fluctuations in insulin and all substrates occurred during regimen A. Persistent hyperinsulinemia throughout regimen A may have impaired the oxidation of exogenous fat. The substrate-hormonal profiles observed during regimen B approximated the normal postabsorptive state and were stable throughout the infusion period. The results of this study suggest that exogenous fat should be administered as a continuous infusion.

3-Hydroxybutyric Acid↗
PubMedDate not supplied

Alternative intake.

Explore the source record for details and available documents.

Catheterization, Peripheral↗