What is TPN and when do we need it?
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- čas přidán 25. 07. 2024
- How much fluid does the body need?
What is Total Parenteral Nutrition (TPN) and why is it important?
What are the daily energy requirements?
In what patients do metabolic needs differ?
What is the respiratory quotient? Why is it important and how do you calculate it?
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Sabiston's Textbook of Surgery citizensurgeon.co/Sabiston
Moore's Clinically Oriented Anatomy citizensurgeon.co/Moore
Netter's Anatomical Atlas citizensurgeon.co/Netter
Schwartz Principles of Surgery citizensurgeon.co/Schwartz
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In this second surgery tutorial on Surgical Nutrition we're going to talk about TPN as fluid and energy. This is absolutely essential to understanding TPN. I always tell the medical students and residents when you think about TPN, think of it of a bag of fluid and energy. How much fluid does your patient need? How much energy do they need?
Definitely check out the first video if you haven't watched that yet and the metabolic response to injury videos as they are key to understanding surgical nutrition and TPN...absolute prerequisites.
FAST FORWARD WITH THESE TIMESTAMPS
Start 00:00
Clinical Case - Nutritional Assessment 01:06
TPN is just a bag of Fluid and Energy 05:01
What are typical energy requirements? 06:41
What is indirect calorimetry? 09:52
How do you use the Respiratory Quotient? 11:25
Summary 14:10
REFERENCES
Indirect calorimetry: citizensurgeon.co/Calorimetry
Obesity and Resting Energy Expenditure: citizensurgeon.co/obesityenergy
Norton's General Surgery citizensurgeon.co/Norton
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WHO AM I?
I'm Dr. Erik Pearson, FACS and I am a board certified pediatric surgeon living in Las Vegas. I make surgical education videos on all topics in general surgery as well as talks on lifestyle design as a surgeon, book reviews, and studying effectively. I also write a weekly newsletter called the Saturday Six where I identify Six different discoveries of the week. You can get the weekly newsletter by signing up to the CITIZENSURGEON Community!
DISCLAIMER
While my aim is to help educate you for the ward, the surgical ICU, the operating room and your exams remember these videos are not a replacement for your reading, your medical school and residency preparation and most important your own decision making. Good luck and enjoy!
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Very good explanation, thank you !
Very well presented...as a surgery resident I know that fluid and energy requirements of a surgical pt.(pre and post-op) are the most underrated and overlooked things which if followed correctly can make a huge difference in management. 👍
Absolutely, it’s definitely one of those chapters I skipped over a couple of times before I sat down and said “dude, you gotta learn this.” In addition to your surgery textbook of choice chapter I recommend reading Marino’s discussion of fluids in The ICU book
Very nice sir. It’s really helpful in understanding the chapter in the textbooks. Thankyou for making these videos. Please do more
Thanks so much for the feedback, two just finishing the edits on
Hey Dr. Pearson, thanks for making these videos, they are super helpful. I see you use evernote a lot. Could you discuss how you organize your notes regarding textbook readings, procedures, as well as clinical information you encounter in the day-to-day
Joshua Wechsler thanks so much for the feedback. I’ll definitely put together a talk on how to get organized! In the mean time I wrote a blog post on Evernote you may find helpful. Check this out and let me know what you think. www.citizensurgeon.com/evernote/
Thank you so much for these videos! They are saving me for my EOR PA exams!
Kathryn Fossaceca that’s totally awesome, second bleeding video coming out in the next day! Let me know what would help!
Thank you 💓
May you continue to make many more informative videos 🙌
Marianne Castro thanks so much! If you found it helpful please share with your mates! Have a new video on blood type, type and screen and type and cross coming out in the next few days, it will be a good one!
@@citizensurgeon Sure doctor 🥰 Gonna share it to all those medical students who are also struggling in SURGERY! Thank you for the big help🙌🙌 God bless you! #DOCTOROFMEDICINE
Amazing, thank you for that!
great guide and very beneficial thank you so much, let me ask you this if you don't mind,,, while infusion and administering TPN the color of the contents in the bag changes from clear to slightly cloudy. Should i abruptly stop the infusion or let it complete??? please guide
Man!!! your videos are live saving🙌🙌
Awesome so glad you found them helpful!!
Great video thank you!
Thank you! Happy to hear you enjoyed it!
Normal range of RQ = 0.7 to 1?
Thank you for all your videos!
Hey Mohammed, you're welcome! Try not to think of it as a "normal range". Think of it has what the body is burning at a particular RQ. So if we want to say that "normal" is when we're burning carbohydrates, our usual non starvation mode then the RQ would be 0.9-1. If we're burning proteins then it will drop down to 0.8 and if we're burning fats it would be 0.7. Also if it's greater than 1 remember we're being overfed. Hope this helps!
TPN is severely damaging my baby niece's liver (pre-term baby with an adjusted age of 2 months). What can be adjusted to my TPN less taxing on her liver? Apparently the hospital has already tried Omega-van and Smof to no avail. Currently she cannot feed through the mouth. Any advise/insight would be appreciated.
I’m sorry to hear that and now I’m only realizing that was 7 months ago! There are a few things that can be done to adjust the lipids in TPN such as changing to SMOF or Omegavan. Definitely talk with your Peds GI doctor!
Just a revision of what i read in book ❤
Thanks for the comment! Hopefully that’s a good thing :)
Do you've a video on ABGs doc?
I don’t but I’ll make one, I have a few tricks to pass along!
Make more surgical videos
They are on the way :)
strong jaw bro
Ha, must be the lighting