Yu dɔn ɛva go na ɔspitul fɔ si pɔsin we nɔ ebul fɔ it wit in mɔt, ɛn dɛn de gi dɛn wata tru wan big bag tru wan vein? Bɔku tɛm wi kin tink bɔt am as salin. Bɔt nɔto ɔltɛm i kin jɔs bi salin. Sɔmtɛm na spɛshal wata we gɛt ɔl di tin dɛn we pɔsin nid fɔ liv. Na dat wi kin kɔl ‘intravenous nutrition’, ɔ insay mɛrɛsin, Parenteral Nutrition .
Fɔ tɔk am simpul wan, wetin na Parenteral Nutrition?
Fɔ tɔk am simpul wan, dis na we yu baypas yu dijestiv sistɛm (di ɔl sistɛm frɔm yu mɔt to yu an) ɔl ɛn deliv nyutriɛnt dɛn dairekt to yu bɔdi tru wan blɔd vesel. di wכd "parenteral" min "ausayd di dijestiv sistεm."
Yu go dɔn yɛri bɔt aw fɔ it tin dɛn we yu kin it na yu bɔdi. Dis min se yu fɔ gi wata it dairekt insay di bɛlɛ ɔ smɔl intestin tru wan tiub we dɛn put insay di nos ɔ wan smɔl opin na di bɛlɛ. bכt wit parenteral nyutrishכn, dεn de baypas dis כl sistεm εn dεn ad nyutriεnt dεm dairekt insay di bכdi. Insay sɔm mɛrɛsin, dɛn kin nid fɔ du dis fɔ shɔt tɛm ɔ fɔ lɔng tɛm. Dɛn kin gi sɔm pipul dɛn dis fɔ ad pan di it we dɛn kin it wit dɛn mɔt. Ɔda wan dɛn nid fɔ gɛt ɔl dɛn kalori tru dis it we dɛn kin put insay dɛn bɛlɛ.
Wetin na di men kayn we fɔ du dis?
dis mכtכd fכ parenteral nyutrishכn kin sheb to tu men tכp dεm. Wan de bay di amount of nyutrishɔn we dɛn gi, ɛn di ɔda wan de bay di kayn vein we dɛn yuz fɔ gi nyutrishɔn. Lɛ wi ɔndastand dɛn tu tin ya klia wan.
1. Sɔt bay di amount of nyutrishɔn we dɛn gi
Tu men kayn dis de.
| Nutrishɔnal sistɛm | Fɔ tɔk am simpul wan... |
|---|---|
| Patɛl Parenteral Nutrishɔn (PPN) . | Dɛn kin gi dis apat frɔm ɔda we dɛn we dɛn kin yuz fɔ it tin dɛn. Imajin se pɔsin kin it smɔl wit in mɔt, bɔt i nɔ go du fɔ gi di bɔdi di tin dɛn we i nid, ɛn i de sɔfa bikɔs i nɔ de it fayn. If na so i bi, dɛn kin yuz dis we fɔ gi sɔm pan di tin dɛn we nɔ de ɔ di ɛkstra kalori dɛn we nɔ de. |
| Tכtal Parenteral Nutrishכn (TPN) . | Dis na we fɔ gi kɔmplit it tru wan vein. Dis kin nid fɔ pipul dɛm wae nɔr kin ebul fɔ yuz dɛn dijestiv sistɛm atɔl. Bikɔs ɔf sɔm mɛrɛsin dɛn, dɛn nɔ kin ebul fɔ dayjɛst it ɛn tek di tin dɛn we de insay di bɔdi. כda tεm dεm, i nid fכ gi di dijestiv sistεm rεst kכmplit εn alaw am fכ hεl. If na so i bi, dɛn kin yuz TPN. |
2. Klasifikɛshɔn bay di kayn vein we dɛn yuz
| Tayp fɔ di vein | Tɔk bɔt |
|---|---|
| tru wan men vein (Sεntral Parenteral Nutrishכn - CPN) . | Dis involv fɔ it insay wan big, men vein na di bɔdi. dis kin bi di Superior Vena Cava, we na wan big vein we de כnda di kכlabon we de go dayrekt to di at. biכs dis vein big, i kin gi wan mכr kכnsantreyt, hεy kalori likid nyutriεnt kwik kwik wan. dis na di rizin we mek dεn de yuz am fכ gi tכtal parenteral nyutrishכn (TPN). |
| tru wan sכm sכm, pεriferal vein (Pεrifεral Parenteral Nutrishכn - PPN) . | Dis kin bi bay we dɛn gi nyutrishɔn insay wan smɔl vein na di an, leg, ɔ nɛk. Bikɔs i izi fɔ du, dɛn kin yuz dis we fɔ gi tɛmporari pat pan it (PPN). |
Wetin dis wata we de mek pɔsin gɛt fayn fayn tin dɛn gɛt?
Dis na fɔmula we dɛn mek wit kemikal. Bɔt dis nɔto sɔntin we dɛn kin gi ɔlman di sem we. Akɔdin to wetin yu bɔdi nid, bay di rizɔlt fɔ yu blɔd tɛst, dɛn kin gi yu wan kɔstɔmayt nyutrishɔn sɔlvishɔn.
I kin gɛt ɔl di siks impɔtant tin dɛn fɔ di bɔdi insay difrɛn amɔnt dɛn:
- Wata
- Kabohaydrɛt (fɔ ɛnaji) .
- Protein dεm (fכ di bכdi gro εn rεpa) .
- Fεt (fכ εnεji εn εsεnsial fεt asid dεm) .
- Vitamin dɛn we dɛn kin yuz
- Minral sɔl dɛn we dɛn kin yuz
Dis fכmula fכ it fכ it so komplit dat, if i want, pכsin kin liv pan dis sistεm fכ di rεst כf in layf we i nכ tek enitin bay mכt.
Us sityueshɔn dɛn kin yuz dɛn we ya?
Ustɛm i nid fɔ gɛt pat pan it (PPN)?
Bɔku tɛm, dɛn kin yuz PPN fɔ sɔm tɛm. fכ egzampl, dεn kin yus am fכ gi pכsin in εnεji kwik bifo dεn chenj am sכmtεm to tyub fכ it כ כral fכ it. Dɔn bak, di wan dɛn we de na ɔspitul fɔ lɔng tɛm kin gɛt prɔblɛm wit dɛn it fɔ difrɛn rizin dɛn. PPN dεn kin yus bak fכ gi dεm כda nyutrishכn.
Ustɛm dɛn nid fɔ gɛt tɔtal parenteral nyutrishɔn (TPN)?
If yu dijestiv sistɛm nɔ de wok atɔl, ɔ if yu gɛt gastrointestinal sik we nid fɔ rɛst kɔmplit wan fɔ da sistɛm de, yu kin nid TPN.
Na sɔm patikyula sityueshɔn dɛn we TPN kin nid:
- Big big ɔpreshɔn fɔ di bɛlɛ
- Kimotɛrapi fɔ kansa
- di bכdi we de fכm na di intestinal dεm dεn dכn dכn (Intestinal ischemia) .
- di tin dεm we de ambɔg di intestinal na di sכm כ big intestinal
- Intestinal dysfunction (Ileus we de te) .
- Blɔd we de kɔmɔt na di bɛlɛ
- Damej to di intestines bikɔs ɔf redyushɔn tritmɛnt (Radiation enteritis) .
- Bɔn pikin we dɛn bɔn bifo tɛm pasmak
- Nekrotizing enterocolitis na bebi pikin dεm
- Dayarɛa fɔ lɔng tɛm
- Inflammatory bowel diseases lɛk di sik we dɛn kɔl Crohn’s disease
- Short bowel syndrome (na wan sik we kin apin afta dɛn dɔn ɔpreshɔn wan pat pan di intestinal) .
- Graft-versus-host sik na di gut
Aw dɛn kin du di pripia ɛn implimɛnt fɔ dis tritmɛnt?
Dis na wan tim we gɛt dɔktɔ dɛn we dɛn dɔn plan fɔ du ɛn we dɛn de wok togɛda.
Fɔ rɛdi fɔ tritmɛnt
Yu mɛdikal tim (dɔktɔ, nɔs, ɛn nyutrishɔnist dɛn) go tek tɛm luk yu wɛlbɔdi istri, bɔdi mas indeks (BMI), ɛn blɔd tɛst rizɔlt fɔ no di it we yu nid. Dis nyutrishɔnal likwid na spɛshal pɔsin de pripia am insay di dos dɛn we go du fɔ 24 awa. I fɔ de na frij te di de we yu nid am. Dɛn kin pul am sɔm awa bifo yu yuz am ɛn alaw am fɔ kam na rum tɛmpracha.
Aw fɔ put kateshɔn insay di bɔdi
Fɔ put di tiub we dɛn kɔl kateta insay yu bɔdi na smɔl ɔpreshɔn. Bifo dɛn du dis, dɛn go gi yu wan mɛrɛsin we de mek yu nɔ fil fayn fɔ mek yu nɔ fil pen ɛn mek yu at kol. Dɔn, dɛn go klin di say we dɛn go put di kateshɔn fayn fayn wan ɛn disinfɛkt am.
Di dɔktɔ kin put wan gaydway insay di vein bay we i yuz nidul, dɔn i kin pul di nidul ɛn trɛd di kateshɔn tru di waya insay di vein. Dɛn kin yuz ɔltra saund ɔ ɛkstrem rayt fɔ chɛk if i de na di rayt ples.
Dɛn kin yuz tri men kayn kateshɔn dɛn:
- External “tunneled” catheter: Dɛn mek dis fɔ go shɔt distans ɔnda di skin ɛn kɔmɔt na difrɛn say.
- Kateta we dɛn dɔn put ful wan: Dis de ɔnda di skin ɔlsay. we nid de fכ it, dεn kin put nidul insay wan spεshal pכt כnda di skin εn kכnekt am to am.
- di sεntri kateta we dεn put pεriferal (PICC): dεn kin put dis tru wan vein na di כp an εn tכd am to wan men vein nia di at. Dɛn kin yuse dis fɔ pipul dɛm wae nid it fɔ lɛs dan 6 wik.
Di tin we impɔtant pas ɔl na fɔ du dis ɔl prɔses ɔnda rili klin, stɛriyl kɔndishɔn, bikɔs risk de fɔ mek yu gɛt di sik.
Aw dɛn de gi ɛn wach di it we dɛn de it?
Fɔ it kin bi 10-12 awa, so bɔku pipul dɛn kin du am na nɛt we dɛn de go slip. Dɛn kin du dis tritmɛnt na ɔspitul, say fɔ kia fɔ lɔng tɛm, ɔ ivin na os .
If yu de du dis na os, di mɛdikal tim go gi yu ɔ di pɔsin we de kia fɔ yu ful trenin, lɛk aw fɔ no di sayn dɛn we de sho se yu gɛt di sik, aw fɔ kip di ikwipmɛnt klin, ɛn aw fɔ chenj di tyub dɛn.
Di mɛdikal tim go de wach yu ɔltɛm we dɛn de trit yu.
- I de mɛzhɔ di wata we de go insay ɛn kɔmɔt na yu bɔdi.
- Dɛn kin chɛk di wet ɛn ayt ɔltɛm.
- Dɛn kin du blɔd tɛst ɔltɛm fɔ si if dɛn nid fɔ chenj di fɔmula we de gi di it.
Speshali, dɛn kin pe atɛnshɔn pan dɛn tin ya:
- Ilektrolayt ɛn di kidni wok (BUN/Creatinine) .
- Di blɔd shuga lɛvɛl (avɔyd aypa glycemia ɔ haypoglycemia) .
- Minral lɛvɛl dɛn
- Di indikɛtɔ dɛn we di liva de wok (Aminotransferases, Bilirubin) .
Wetin na di bɛnifit ɛn denja we dɛn kin gɛt we dɛn de du dis we?
Lɛk ɛni mɛrɛsin, dis wan gɛt bɛnifit ɛn prɔblɛm dɛn.
Bɛnifit dɛn
Di men bɛnifit fɔ dis we na dat i de gi yu dijestiv sistɛm di rɛst we i nid fɔ wɛl afta yu gɛt siriɔs sik ɔ ɔpreshɔn.. I kin ɛp bak fɔ mek di bɔdi strɔng bay we i de gi di wan dɛn we de na ɔspitul fɔ lɔng tɛm di it we i nid, mɔ di wan dɛn we dɔn ol. Na tritmɛnt we de sev layf fɔ di wan dɛn we dɛn dijestiv sistɛm dɔn pwɛl fɔ ɔltɛm ɛn fɔ pikin dɛn we dɛn bɔn bifo tɛm we nɔ ebul fɔ it nɔmal wan.
Risk ɛn Kɔmplikɛshɔn dɛn
dis mכtכd de kכri hכy risk fכ komplikashכn pas di εntal fכ it. di tu men prכblεm dεm na di risk fכ di jεm dεm fכ go insay di bכdi tru di kateshכn εn di wik we di dijestiv sistεm de wik biכs fכ di yus fכ lכng tεm.
| Kɔmɔn kɔmplikeshɔn | Wan simpul ɛksplen |
|---|---|
| Sik we de prɛd | Baktri kin go insay di blɔd tru di kateshɔn. If dis infekshɔn prɛd ɔlsay na di bɔdi, i kin mek pɔsin gɛt wan sik we de mek pɔsin in layf de pan denja we dɛn kɔl sɛpsis . |
| Blɔd we de klɔt | di bכdi kin fכm usay di kateshכn kכnekt to di vein. |
| di wik we di dijestiv sistεm de wik (GI atrophy) . | Afta lɛk tu wiks we dɛn nɔ yuz di sistɛm, di we aw i de wok kin bigin fɔ go dɔŋ. Bɔt smɔl smɔl i kin kam bak to nɔmal we yu bigin fɔ it bak. |
| Di shuga lɛvɛl imbalans | Hyperglycemia ɔ hypoglycemia na tin dɛn we kin apin ɛn dɛn kin ebul fɔ kɔntrol am bay we dɛn ajɔst di insulin ɛn di it we dɛn de gi. |
| Liva prɔblɛm dɛn | Na lɛk 50% pan di pipul dɛm wae de tek dis tritmɛnt fɔ lɔng tɛm kin gɛt liva sik (PNALD) insay 5-7 ia. Wi nɔ no di rayt tin we mek dis apin. |
| Prɔblɛm dɛn we de na di gal blad | biכs di dijestiv sistεm nכ de wok, di bayl we de na di gal blad nכ de kכmכt εn i kin kכmכt, fכ mek stכn. |
| Bon dεminεralayzεshכn | Pipul dεm we de gεt dis tritmεnt fכ lכng tεm kin gεt sik dεm we de mek dεn bon dεm lεk כ stioporosis bikoz dεn nכ gεt vaytam in εn minral dεm (kalsiכm, magnεsium, vaytam in D). |
Apat frɔm dat, ɔda tin dɛn de we kin mek pɔsin fil bad, lɛk fɔ wund we dɛn de put kateshɔn, fɔ put wata pasmak, ɛn fɔ fil angri.
Aw yu kin bigin fɔ it wit yu mɔt bak?
Pan ɔl we dɛn kin du parenteral nutrition fɔ lɔng tɛm, dɔktɔ dɛn kin tray ɔltɛm fɔ chenj yu bak to tyub fiding ɔ ɔral feeding kwik kwik wan. Di rizin fɔ dis na fɔ avɔyd prɔblɛm dɛn we go de fɔ lɔng tɛm.
dis transishכn de du sכ mtεm sכmtεm εn slo biכs , lεk yu כndalayn mεdikal kכndishכn, wan dijestiv sistεm we dεn "dormant" fכ sכm tεm nכ go stat fכ wok wan wan.
1. Start wit klia wata it .
2. If di bɔdi de ansa am fayn, dɔn chenj to it we ful-ɔp wit wata .
3. Fɔ dɔn, smɔl smɔl, yu fɔ it tin dɛn we strɔng .
Ivin afta dɛn dɔn stɔp dis tritmɛnt, di mɛdikal tim go kɔntinyu fɔ wach yu wet ɛn di it we yu de it fɔ sɔm tɛm.
Parenteral Nutrition na mɛrɛsin wae dɛn kin yuse pan de sik wae tranga pasmak, bɔt sɔmtɛm i kin nid fɔ sev pɔrsin in layf. If dis nid fɔ du fɔ yu ɔ pɔsin we yu lɛk, i kin tranga smɔl ɛn i kin bi nyu ɛkspiriɛns. Bɔt afta sɔm tɛm, i go bi pat pan di tin dɛn we yu kin du ɛvride. Di tin we impɔtant pas ɔl na fɔ fala di instrɔkshɔn dɛn we di mɛdikal tim gi dɛn gud gud wan ɛn fɔ tɛl dɛn bɔt ɛni prɔblɛm.
Mɛsej we dɛn kin kɛr go na os
- Parenteral Nutrition na we fɔ gi nyutrishɔn dairekt insay di blɔd tru wan vein we dɛn nɔ ebul fɔ yuz di dijestiv sistɛm.
- tu men kayn dεm de: PPN, we dεn gi as supliment nyutrishכn, εn TPN, we de gi komplit nyutrishכn.
- Pan ɔl we dis na tritmɛnt we de sev pɔsin in layf, siriɔs prɔblɛm dɛn de, lɛk infɛkshɔn, blɔd we de rɔtin, ɛn liva prɔblɛm.
- Dɛn fɔ du dis tritmɛnt ɔltɛm ɔnda wan tim we gɛt dɔktɔ dɛn, nɔs dɛn, ɛn pipul dɛn we sabi bɔt it.
- If yu ɔ pɔsin we yu lɛk gɛt fɔ du dis tritmɛnt na os, i impɔtant fɔ gɛt di rayt trenin ɛn tek kia gud gud wan wit klin. If yu gɛt ɛni wɔri ɔ kwɛstyɔn, tɔk to yu dɔktɔ wantɛm wantɛm.
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