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INTRAVENOUS ALIMENTATION: Title and subTitle BreakWITH SPECIAL REFERENCE TO PROTEIN (AMINO ACID) METABOLISM

ROBERT ELMAN, M.D.; D. O. WEINER, M.D.
[+] Author Affiliations

Aided by a grant from the Louis D. Beaumont Fund.

Read before the Section on Gastro-Enterology and Proctology at the Eighty-Ninth Annual Session of the American Medical Association, San Francisco, June 16, 1938.


ST. LOUIS

From the Department of Surgery, Washington University School of Medicine, and the St. Louis City, the St. Louis Children's and the Barnes hospitals.


JAMA. 1939;112(9):796-802. doi:10.1001/jama.1939.02800090006002
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Intravenous (as a method of parenteral) alimentation becomes important whenever the nutritional needs of the body cannot be met by oral feeding; it becomes essential when death threatens because of nutritional deficiencies which can be remedied in no other way. These nutritional needs comprise six elements: water, salts, carbohydrate, protein, fat and vitamins. As far as water, salts and carbohydrate are concerned, intravenous alimentation is now a commonplace and extensively used procedure. For example, at the Barnes Hospital 125 liters and at the St. Louis City Hospital 200 liters of saline and dextrose solutions for subcutaneous and intravenous administration are used daily. Why have the remaining three nutritional elements been overlooked? If carbohydrate is important, why not protein, fat and vitamins? The answer lies partly in lack of information on the real needs for protein, fat and vitamins in patients more or less completely, though temporarily, unable to ingest any

REFERENCES

Holt, L. E., Jr.; Tidwell, H. C., and Scott, T. F. M.: J. Pediat. 6:151 ( (Feb.) ) 1935;.
Burr, G. O., and Burr, M. M.: J. Biol. Chem. 82:345 ( (May) ) 1929;.
Mecray, P. M., Jr.; Barden, R. P., and Ravdin, I. S.: Surgery 1:53 ( (Jan.) ) 1937;.
Holman, R. L.; Mahoney, E. B., and Whipple, G. H.: J. Exper. Med. 59:269 ( (March) ) 1934;.
Groen, Julia: New England J. Med. 218:247 ( (Feb. 10) ) 1938;.
Elman, Robert: Proc. Soc. Exper. Biol. & Med. , to be published.
Science 86: 298 [ (Oct. 1) ] 1937;
Physiol. Rev. 18:109 [ (Jan.) ] 1938;
Rose, W. C.: Science 86:298 ( (Oct. 1) ) 1937;.
Van Slyke, D. D., and Meyer, G. M.: J. Biol. Chem. 16:197, 1913;.
Henrique, V., and Andersen, A. C.: Ztschr. f. physiol. Chem. 88: 357, 1913;.
Abderhalden, E.; Frank, F., and Schittenhelm, A.: Ztschr. f. physiol. Chem. 63:215, 1909;.
Griesbach, W.: Klin. Wchnschr. 2:1926, 1922;.
This product was supplied by Mead Johnson & Co., of Evansville, Ind. The added tryptophan, cystine and methionine were obtained from the Eastman Kodak Company.
Kemmerer, H. S.: Personal communication to the authors.
Elman, Robert: Proc. Soc. Exper. Biol. & Med. 37:437 ( (Dec.) ) 1937;.
Elman, Robert: Proc. Soc. Exper. Biol. & Med. 37:610 ( (Jan.) ) 1938;.
Peters, J. P., and Van Slyke, D. D.: Quantitative Clinical Chemistry , Baltimore, Williams and Wilkins Company, 1931;, vol. 1, p. 394.
Elman, Robert: Proc. Soc. Exper. Biol. & Med. 36:867 ( (June) ) 1937;.
Weech, A. A.; Goettsch, E., and Reeves, E. B.: J. Exper. Med. 61: 299 ( (March) ) 1935;.

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Holt, L. E., Jr.; Tidwell, H. C., and Scott, T. F. M.: J. Pediat. 6:151 ( (Feb.) ) 1935;.
Burr, G. O., and Burr, M. M.: J. Biol. Chem. 82:345 ( (May) ) 1929;.
Mecray, P. M., Jr.; Barden, R. P., and Ravdin, I. S.: Surgery 1:53 ( (Jan.) ) 1937;.
Holman, R. L.; Mahoney, E. B., and Whipple, G. H.: J. Exper. Med. 59:269 ( (March) ) 1934;.
Groen, Julia: New England J. Med. 218:247 ( (Feb. 10) ) 1938;.
Elman, Robert: Proc. Soc. Exper. Biol. & Med. , to be published.
Science 86: 298 [ (Oct. 1) ] 1937;
Physiol. Rev. 18:109 [ (Jan.) ] 1938;
Rose, W. C.: Science 86:298 ( (Oct. 1) ) 1937;.
Van Slyke, D. D., and Meyer, G. M.: J. Biol. Chem. 16:197, 1913;.
Henrique, V., and Andersen, A. C.: Ztschr. f. physiol. Chem. 88: 357, 1913;.
Abderhalden, E.; Frank, F., and Schittenhelm, A.: Ztschr. f. physiol. Chem. 63:215, 1909;.
Griesbach, W.: Klin. Wchnschr. 2:1926, 1922;.
This product was supplied by Mead Johnson & Co., of Evansville, Ind. The added tryptophan, cystine and methionine were obtained from the Eastman Kodak Company.
Kemmerer, H. S.: Personal communication to the authors.
Elman, Robert: Proc. Soc. Exper. Biol. & Med. 37:437 ( (Dec.) ) 1937;.
Elman, Robert: Proc. Soc. Exper. Biol. & Med. 37:610 ( (Jan.) ) 1938;.
Peters, J. P., and Van Slyke, D. D.: Quantitative Clinical Chemistry , Baltimore, Williams and Wilkins Company, 1931;, vol. 1, p. 394.
Elman, Robert: Proc. Soc. Exper. Biol. & Med. 36:867 ( (June) ) 1937;.
Weech, A. A.; Goettsch, E., and Reeves, E. B.: J. Exper. Med. 61: 299 ( (March) ) 1935;.
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