[in Japanese]

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[in Japanese]

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It has been reported that colloidal iron (III) admixed in total parenteral nutrition (TPN) solutions converts to free iron (II) over time. In this study, the in vivo kinetics of free iron in TPN admixtures was analyzed using ⁵⁹Fe in rats. After catheterization, rats in the free iron group were continuously infused with a TPN solution containing free iron for two days ; in the colloidal iron group, colloidal iron was infused separate from a TPN solution without iron. Then, both groups were infused for 2 hours with ⁵⁹Fe-labelled solutions of the same composition as the previous ones, followed by non-labelled solutions. In the colloidal iron group, ⁵⁹Fe was distributed to the liver first, and subsequently to bone marrow, and further to red blood cells over time. Just after the 2-hour infusion of ⁵⁹Fe, 50.8% of ⁵⁹Fe was already distributed in the liver. At 168 hours, 52.8% was distributed in red blood cells and 21.7% remained in the liver. In the free iron group, a high concentration of ⁵⁹Fe was directly transferred to bone marrow. At 4 hours after the 2-hour infusion of ⁵⁹Fe, 56.1% was distributed to bone marrow. Afterward, ⁵⁹Fe moved to red blood cells from bone marrow, and 40.3% was distributed in red blood cells at 24 hours, 63.4% at 72 hours and 68.6% at 168 hours. Compared to the colloidal iron group, the rate and the ratio of iron transition to red blood cells were higher in the free iron group. These results suggest that free iron (II) in TPN admixtures may promptly bind to transferrin in the blood, is taken up by erythroblasts and is used for hemoglobin production. Therefore, the dissociation of colloidal iron (III) to free iron (II) would not impair the utility of iron.

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Background : Negative Pressure Wound Therapy (NPWT) promotes wound heeling by stimulating tissue growth under a closed environment. We evaluated the nutritional intake during the NPWT therapy for postoperative wound disruption.
Method : A total of 33 patients who underwent NPWT for postoperative wound disruption after digestive surgery from June 2012 to October 2015 at Osaka National Hospital were enrolled in the current study. Patients' background characteristics, details of wound disruption and nutritional parameters were retrospectively analyzed.
Results : The median duration of NPWT was 15 days (4-33 days). We compared the background characteristics and nutritional parameters in the early recovery group (the median therapeutic period≦15 days, n=18) and delayed recovery group (≧16 days, n=15). The background characteristics were comparable between the two groups. The amount of calories (29.3 vs. 24.6 kcal/IBW ･ kg, p=0.12) and protein (1.1 vs 0.9 g/IBW ･ kg, p=0.08) tended to be greater in the early than in the delayed recovery group. The number of patients who received nutritional intervention by NST and who took Abound TM during the treatment did not differ between the two groups.
Conclusion : Even though nutritional intake of the early recovery group was greater than the delayed recovery group, we could not identify the optimal nutritional support for patients using NPWT for wound disruption because of the small sample size. A larger sample size cohort study or prospective interventional study will be necessary to establish more conclusive evidence.

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