Huina nui o ka meaʻai makua - pēpē

ʻO ka nui o ka meaʻai makua (TPN) kahi hana o ka hānai ʻana e kāpae i ka tract gastrointestinal. Hāʻawi ʻia nā wai i loko o kahi aa e hāʻawi i ka hapa nui o nā meaola a ke kino e pono ai. Hoʻohana ʻia ke ʻano ke hiki ʻole i kahi kanaka ke loaʻa a hānai ʻole i nā wai e ka waha.

Hāʻawi ʻia nā maʻi hānau hou a maʻi ʻole paha iā TPN ma mua o ka hoʻomaka ʻana i nā hānai ʻē aʻe. Loaʻa iā lākou kēia ʻano hānai ke hiki ʻole ke omo i nā meaola ma o ka ʻōpū o ka ʻōpū no ka manawa lōʻihi. Hāʻawi ʻo TPN i kahi hui o ka wai, electrolytes, sugars, amino acid (protein), nā wikamina, nā minelala, a me nā lipid pinepine (nā momona) i loko o ka aa o ke pēpē. Hiki iā TPN ke hoʻōla i nā pēpē liʻiliʻi a maʻi loa paha. Hiki iā ia ke hāʻawi i kahi pae ʻoi aku ka maikaʻi ma mua o ka hānai infravenous (IV) maʻamau, kahi e hāʻawi ai i nā kō a me nā paʻakai wale nō.

ʻO nā pēpē i loaʻa i kēia ʻano hānai pono e kiaʻi pono ʻia e ʻike pono ke loaʻa nei ka meaʻai kūpono. Kōkua ke koko a me ka mimi i ka hui mālama ola e ʻike i nā loli e pono ai.

PEHEA KA MEA I HANA AI TPN?

Hoʻokomo pinepine ʻia kahi lālani IV i kahi aa i ka lima o ka pēpē, ka wāwae, a i ʻole ka poʻo poʻo. Hiki ke hoʻohana ʻia kahi aa nui ma ka pihi ʻōpū (umbilical vein). I kekahi manawa hoʻohana ʻia kahi laina ʻoi aku ka lōʻihi ʻo IV, i kapa ʻia i ka laina kikowaena a i ʻole ke kikowaena i hoʻokomo ʻia i ka catheter kikowaena (PICC), no nā hānai IV lōʻihi.

HEAHA ANA NA HIKI?

He pōmaikaʻi nui ʻo TPN no nā pēpē hiki ʻole ke loaʻa ka meaʻai i nā ʻano ʻē aʻe. Eia nō naʻe, hiki i kēia ʻano hānai ke hopena i nā pae maʻamau o ke kō kō, nā momona, a me nā electrolytes.

Hiki i nā pilikia ke ulu ma muli o ka hoʻohana ʻana i nā laina TPN a i ʻole IV. E neʻe paha ka laina ma waho o kahi a clots paha. ʻO kahi maʻi ʻino i kapa ʻia sepsis kahi komikino kūpono o ka laina waena IV. ʻO nā pēpē i loaʻa iā TPN e nānā pono ʻia e ka hui mālama ola.

ʻO ka hoʻohana lōʻihi o TPN e alakaʻi i nā pilikia o ke ake.

IV fluids - pēpē; TPN - nā pēpē; Nā wai kūpikipiki - keiki pēpē; Hyperalimentation - nā pēpē

• Nā pūnaewele wai hoʻowahāwahā

ʻO ke Kōmike ʻAmelika Hui Pū ʻIa Pediatrics (AAP) no ka meaola. Palehua mākua. I: Kleinman RE, Greer FR, eds. Puke Laiki Meaʻai Pediatric. 8th ed. Elk Grove Village, IL: ʻAmelika Hui Pū ʻIa o Pediatrics; 2019: chap 22.

Maqbool A, Bales C, Liacouras CA. Intestinal atresia, stenosis, a me malrotation. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 356.

ʻO Poindexter BB, Martin CR. Nutrient koi / nutritional kākoʻo i ka premature neonate. I: Martin RJ, Fanaroff AA, Walsh MC, hua. ʻO Fanaroff lāua ʻo Martin's Neonatal-Perinatal Medicine. 11th hua. Piladelapia, PA: Elsevier Saunders; 2020: chap 41.