Thanks so much for a great tutorial! I have only discovered your series this afternoon and have already learnt so much! Would you consider a future learning session on albumin and the role of its measurement and when to supplement post-operatively please? Thanks again! :-)
Not a doctor but I’ve been on TPN for 6 years now and just curious about how it works. Good video! Also if anyone watching this has any questions for a long term TPN patient I’d be happy to answer
Thanks , nice work But I think if 1gm of lipid equal 9kcal and with intralipid 10% the volume should be 700 ml . Please could you explain it if l'm wrong
Remember that to find the percentage of a substance in a solution it’s the amount of that substance divided by the total volume of the solution. So in this case if the total volume is 2440 then the amount of dextrose in this volume will be the percentage of the solution. I hope that is clear!
It’s such a great and vexing question and the answer seems to be related to dietary omega six increasing the circulation of arachidonic acid which is proinflammatory. Check out this abstract… Inflammation is a normal process that is part of host defence and tissue healing. However, excessive or unresolved inflammation can lead to uncontrolled tissue damage, pathology and disease. In humans on a Western diet, the omega-6 polyunsaturated fatty acid arachidonic acid (ARA) makes a significant contribution to the fatty acids present in the membrane phospholipids of cells involved in inflammation. ARA is a precursor to a number of potent pro-inflammatory mediators including well described prostaglandins and leukotrienes, which has led to the development of anti-inflammatory pharmaceuticals that target the ARA pathway to successfully control inflammation. Hence, it is commonly believed that increasing dietary intake of the omega-6 fatty acids ARA or its precursor linoleic acid (LA) will increase inflammation. pubmed.ncbi.nlm.nih.gov/29610056/
Thanks for the feedback and I’m sorry about the math error, I’m pumped that it was helpful for you! I’ll make a note in the description about the math. Good luck in your studies and if there is a topic you’d like to see let me know!
I talk about that, there are different energy requirements based on the severity of illness and the respiratory quotient, the patient may need 40kg/day, also important to recognize the possibility of over feeding
Again, thank you so much! You really simplified the information in 30 pages of textbook on this topic.
Thank you for producing this video, you explain things so much better than the text books!
Thanks for the feedback, just finishing a long format video on the trauma assessment, should be out this weekend!
Great learning session there sir.
Dietitian from Kenya.
Thanks so much for a great tutorial! I have only discovered your series this afternoon and have already learnt so much!
Would you consider a future learning session on albumin and the role of its measurement and when to supplement post-operatively please?
Thanks again! :-)
I think I could do a short video on that, for sure thanks for your feedback! Good luck with your studies
Not a doctor but I’ve been on TPN for 6 years now and just curious about how it works. Good video! Also if anyone watching this has any questions for a long term TPN patient I’d be happy to answer
Very helpful . Clear and to the point
Thanks so much for the feedback!!
Just completed the lecture. It was wonderful. Sir, can we've a lecture on surgical audit.
Best wishes from India.
Alish Mehta thank you Alish! Please let me know what you mean by surgical audit...do you mean how to run an effective M&M?
@@citizensurgeon sir, chapter no. 11 of love and bailey , 27 edition
Alish Mehta ok, I’ll check it out, have the book on my shelf ;) let me know if any of the other videos are helpful
Thank you so much 😊
Absolutely! Happy this helped!
Awesome 👍 and beautifully explained!
Tahir! Thanks for the feedback! Let me know if there is another topic you’re interested in learning about!!
Thanks , nice work
But I think if 1gm of lipid equal 9kcal and with intralipid 10% the volume should be 700 ml .
Please could you explain it if l'm wrong
This is so awesome 😊
So happy you enjoyed it!!
How is protein calculated ? Can u explain ?
Do you have a PDFs for self assessment
Working on it! What would be most helpful? Bullet points, questions, questions/explanations, etc?
@@citizensurgeon Questions/explanations. You have a good explanation of the hard core content
@@kangumejustusamooti4915 thanks so much that means a lot
Self assessment questions
Thank you for the suggestion, I'll have these put together and out shortly for each video!
in 17:07 , why are the dextrose grams divided by 2440 instead of 633 ml ?
Remember that to find the percentage of a substance in a solution it’s the amount of that substance divided by the total volume of the solution. So in this case if the total volume is 2440 then the amount of dextrose in this volume will be the percentage of the solution. I hope that is clear!
If omega -6 suppresses immunity wouldn’t it be anti inflammatory instead of pro inflammatory ?
It’s such a great and vexing question and the answer seems to be related to dietary omega six increasing the circulation of arachidonic acid which is proinflammatory.
Check out this abstract…
Inflammation is a normal process that is part of host defence and tissue healing. However, excessive or unresolved inflammation can lead to uncontrolled tissue damage, pathology and disease. In humans on a Western diet, the omega-6 polyunsaturated fatty acid arachidonic acid (ARA) makes a significant contribution to the fatty acids present in the membrane phospholipids of cells involved in inflammation. ARA is a precursor to a number of potent pro-inflammatory mediators including well described prostaglandins and leukotrienes, which has led to the development of anti-inflammatory pharmaceuticals that target the ARA pathway to successfully control inflammation. Hence, it is commonly believed that increasing dietary intake of the omega-6 fatty acids ARA or its precursor linoleic acid (LA) will increase inflammation.
pubmed.ncbi.nlm.nih.gov/29610056/
🎉🎉
Thank you!
Maybe my math is off, please correct me if so but towards the end isn't 110 ml/hr x 24 hrs ~ 2640 ml ?
Ha! Dang! Thank you! That’s embarrassing, hopefully the concepts are clear :)
@@citizensurgeon I learned more in this video than most textbook chapters have done for me so far. Absolute payoff thank you
Thanks for the feedback and I’m sorry about the math error, I’m pumped that it was helpful for you! I’ll make a note in the description about the math. Good luck in your studies and if there is a topic you’d like to see let me know!
But Sir this patient is ICU , I mean the patient should be consider for more than 30 kcal/ kg Sir ????
I talk about that, there are different energy requirements based on the severity of illness and the respiratory quotient, the patient may need 40kg/day, also important to recognize the possibility of over feeding
it says "electroylte"
Good catch!!
nutritionalists?
6638 Brendan Well
919 Camilla Pines