{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T21:03:50Z","timestamp":1784063030116,"version":"3.55.0"},"reference-count":12,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1989,4]]},"abstract":"<jats:p content-type=\"fine-print\">\u2713 Total parenteral nutrition (TPN) has been shown to decrease mortality and to increase the rate of recovery in head-injured patients. However, a recent short-term animal experiment has raised concern over the potential enhancement of vasogenic edema by TPN. The experiment described here was undertaken to examine longer-term effects of TPN infusion on vasogenic edema development. Twenty-four rats received an infusion of a TPN solution (35% glucose) or 0.9% saline at 4 ml\/kg\/hr for 4 or 26 hours following cold injury. In the 4-hour experiment, TPN increased the serum glucose level to 772 \u00b1 57 mg\/dl compared to 160 \u00b1 14 mg\/dl in the saline-treated animals (p = 0.0001) and increased serum osmolality to 312 \u00b1 3 mOsm\/kg compared to 291 \u00b1 3 mOsm\/kg in the saline-treated group (p = 0.0006). In the 26-hour experiment, TPN-infused rats were also hyperglycemic and hyperosmotic by 4 hours postinjury and remained hyperglycemic at 26 hours postinjury (serum glucose level 374 \u00b1 97 mg\/dl compared to 141 \u00b1 3 mg\/dl in saline-treated animals; p = 0.0371). Although by 26 hours the TPN-infused rats appeared hyperosmotic compared to the saline-treated rats, high variability in the TPN group prevented statistical confirmation of this observation (serum osmolality 337 \u00b1 35 mOsm\/kg in the TPN group compared to 287 \u00b1 6 mOsm\/kg in the saline group).<\/jats:p>\n<jats:p content-type=\"fine-print\">A three-way analysis of variance with repeated measures was used to analyze the effect of infusion (saline vs. TPN), time (4 vs. 26 hours), and cold injury on the specific gravity of the five brain regions studied. Cold injury significantly increased edema development in the injured versus uninjured hemisphere for every region studied (p \u2264 0.0034, all five regions), and edema development increased significantly between 4 and 26 hours in three of the five regions (p \u2264 0.0207, all three regions). The infusion fluid was not a significant factor in any of the analyses. In conclusion, TPN infusion produced hyperglycemia and hyperosmolality in cold-injured rats but did not enhance vasogenic edema development in any brain region studied.<\/jats:p>","DOI":"10.3171\/jns.1989.70.4.0623","type":"journal-article","created":{"date-parts":[[2009,5,8]],"date-time":"2009-05-08T16:14:21Z","timestamp":1241799261000},"page":"623-627","source":"Crossref","is-referenced-by-count":13,"title":["The effect of total parenteral nutrition on vasogenic edema development following cold injury in rats"],"prefix":"10.3171","volume":"70","author":[{"given":"David J.","family":"Combs","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Ott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela S.","family":"McAninch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Dempsey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Acta Neurochir","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/BF01414613","article-title":"Regional cerebral blood flow and regional metabolism in cold induced oedema.","volume":"29","year":"1973"},{"key":"b2","series-title":"Br J Anaesth","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1093\/bja\/57.1.18","article-title":"Brain oedema following brain ischaemia and the influence of therapy.","volume":"57","year":"1985"},{"key":"b3","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"530","DOI":"10.3171\/jns.1978.49.4.0530","article-title":"A simple gravimetric technique for measurement of cerebral edema.","volume":"49","year":"1978"},{"key":"b4","series-title":"Intracranial Pressure VII.","article-title":"The effect of hyperglycemia on the progression of vasogenic edema following cold injury","year":"1989"},{"key":"b5","series-title":"Neurology","doi-asserted-by":"publisher","first-page":"1239","DOI":"10.1212\/WNL.32.11.1239","article-title":"Moderate hyperglycemia augments ischemic brain damage: a neuropathological study in the rat.","volume":"32","year":"1982"},{"key":"b6","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"906","DOI":"10.3171\/jns.1983.58.6.0906","article-title":"The favorable effect of early parenteral feeding on survival in head-injured patients.","volume":"58","year":"1983"},{"key":"b7","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1038\/jcbfm.1981.34","article-title":"Brain lactic acidosis and ischemic cell damage: 1. Biochemistry and neurophysiology.","volume":"1","year":"1981"},{"key":"b8","series-title":"Acta Neurol Scand","first-page":"1","article-title":"Clinical restitution following cerebral ischemia in hypo-, normo- and hyperglycemic rats.","volume":"58","year":"1978"},{"key":"b9","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1161\/01.STR.18.2.464","article-title":"Ischemia in normo-and hyperglycemic rats: effects on brain water and electrolytes.","volume":"18","year":"1987"},{"key":"b10","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"460","DOI":"10.3171\/jns.1986.64.3.0460","article-title":"Effect of parenteral nutrition on cold-induced vasogenic edema in cats.","volume":"64","year":"1986"},{"key":"b11","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"76","DOI":"10.3171\/jns.1987.67.1.0076","article-title":"Effect of total parenteral nutrition upon intracranial pressure in severe head injury.","volume":"67","year":"1987"},{"key":"b12","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"668","DOI":"10.3171\/jns.1987.67.5.0668","article-title":"The effect of nutritional support on outcome from severe head injury.","volume":"67","year":"1987"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/70\/4\/article-p623.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/70\/4\/article-p623.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/70\/4\/article-p623.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:17:56Z","timestamp":1679876276000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/70\/4\/article-p623.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1989,4]]},"references-count":12,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/jns.1989.70.4.0623","relation":{},"ISSN":["0022-3085"],"issn-type":[{"value":"0022-3085","type":"print"}],"subject":[],"published":{"date-parts":[[1989,4]]}}}