Parenteral nutritional support in children with cancer

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Abstract
Acute and chronic starvation is often associated with childhood cancer. Total parenteral nutrition (TPN) with 20% glucose and 3.0% amino acids and minerals and vitamins was instituted to treat or prevent malnutrition in 41 children with cancer, ages 3 mo. to 18 yr. TPN was required for anorexia, vomiting and diarrhea associated with anticancer therapy in 33 patients, for intestinal complications or surgery in 9 and preoperative correction of malnutrition in 2. During TPN, general nutrition and appearance improved in all patients. Weight gain was noted in most. Despite gastrointestinal complications which usually require the interruption of chemotherapy and irradiation, in 21 children treatment could be continued at full dose with nutritional support by TPN. TPN was discontinued in 6 patients when blood cultures became positive. Sepsis was treated successfully by removal of the central venous catheter in all 6 and administration of antibiotics in 3. No metabolic complications were noted. TPN appears to be a safe and effective means of combating the malnutrition which may occur with cancer and its therapy.