Cyclic parenteral nutrition during bone marrow transplantation in children

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Abstract
Nine children underwent ten bone marrow transplants for malignancies and were supported by parenteral alimentation administered in cyclic fashion 18 hours daily. Children received cyclic parenteral nutrition for an average of 29 days, which provided a caloric intake (mean ± SD) of 55.9 ± 18.1 Kcal/kg/day, and a nitrogen intake of 0.28 ± 0.08 g/kg/day. Nutritional status was assessed using nitrogen balance, creatinine‐height index, and visceral protein concentrations including serum albumin, transferrin, and prealbumin. Minimal transient elevation in tests of liver function were observed without marked derangement in blood glucose, electrolytes, or osmolality. Unlike prealbumin, determinations of nitrogen balance, creatinine‐height index, serum albumin and transferrin concentrations did not parallel changes in clinical status. Cyclic parenteral alimentation is a practical approach to the maintenance of nutrition during intensive antitumor therapy and provides an infusion‐free period for the administration of drugs and blood transfusions without interfering with nutritional support. Prealbumin accurately reflects changes in the patient‐s clinical status at any point and is easily and reliably determined.