Nutritional support of bone marrow transplant recipients: a prospective, randomized clinical trial comparing total parental nutrition to an enteral feeding program

Thesis/Dissertation · Tue Jan 01 04:00:00 EST 1985

OSTI ID:6105266

Szeluga, D J

Allogeneic and autologous bone marrow transplantation (BMT) have been associated with nutritionally-depleting side effects. Total parental nutrition (TPN) has become the standard, but it has not been demonstrated that TPN is the appropriate method of nutritional support. Therefore, in a prospective, randomized clinical trial TPN and enteral feeding were compared for their effectiveness in maintaining the nutritional status of patients through the first 29 post-transplant days. Nutritional assessment included measurement of serum proteins, body weight, anthropometry and isotope dilution analysis of body composition. Total body water (TBW) and extracellular fluid (ECF) were quantified by standard radioisotope dilution techniques using tritiated water and /sup 169/ytterbium-diethylenetriaminepentaacetate, respectively as the tracers. Consenting patients 10-58 years of age were stratified by type of BMT (autologous or allogeneic) and randomized to either TPN plus ad libitum oral feeding or the individualized enteral feeding program (EFP), which included one-on-one counseling, meal-by-meal menu selection, special snacks and tube feeding. There were no differences in the rate of hematologic recovery, incidence of graft-versus-host disease, organ toxicity, length of hospitalization or survival. Therefore, the observed changes in body composition were not clinically significant. Even allowing for increased dietary service, the EFP was only half as expensive as TPN. It was concluded that TPN is not superior to the EFP and therefore, TPN should be reserved for patients who demonstrate intolerance to enteral feeding.

• Research Organization: Cornell Univ., Ithaca, NY (USA)
• OSTI ID: 6105266
• Country of Publication: United States
• Language: English

Related Subjects

550201* -- Biochemistry-- Tracer Techniques
59 BASIC BIOLOGICAL SCIENCES
ACETATES
ANIMAL TISSUES
BETA DECAY RADIOISOTOPES
BIOLOGICAL MATERIALS
BODY
BODY FLUIDS
BONE MARROW
CARBOXYLIC ACID SALTS
CHEMICAL COMPOSITION
COMPARATIVE EVALUATIONS
DAYS LIVING RADIOISOTOPES
ELECTRON CAPTURE RADIOISOTOPES
EVEN-ODD NUCLEI
HEMATOPOIETIC SYSTEM
HYDROGEN COMPOUNDS
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPE APPLICATIONS
ISOTOPE DILUTION
ISOTOPES
LABELLED COMPOUNDS
MATERIALS
MINUTES LIVING RADIOISOTOPES
NUCLEI
NUTRITION
ORGANIC COMPOUNDS
ORGANS
OXYGEN COMPOUNDS
PATIENTS
PROTEINS
RADIOISOTOPES
RARE EARTH ISOTOPES
RARE EARTH NUCLEI
SIDE EFFECTS
SURVIVAL TIME
TISSUES
TRACER TECHNIQUES
TRANSPLANTS
TRITIUM COMPOUNDS
WATER
YTTERBIUM 169
YTTERBIUM ISOTOPES