"Principles for Good Practice: Presented to the Seventh Clinical Congress of the American Society for Parenteral and Enteral
Nutrition, Washington, DC" [Reminiscence]
Number of Image Pages:
2 (104,880 Bytes)
Koop, C. Everett
This item is in the public domain. It may be used without permission.
Reproduction and Family Health
Principles for Good Practice: Presented to the Seventh Clinical Congress of the American Society for Parenteral and Enteral
Nutrition, Washington, DC (January 24, 1983)
Vol. 3 -- #7 cover sheet
"Principles for Good Practice"
Presented to the Seventh Clinical Congress of the American Society for Parenteral and Enteral Nutrition
January 24, 1983
Total parenteral nutrition (TPN) is one of the great contributions of the twentieth century to the practice of medicine and
surgery. I was fortunate as a Harrison Fellow in surgical research during the time of World War II to be working on nutritional
aspects of patient care under the aegis of the National Research Council primarily interested, at that time, in nutrition
for the military effort. Some of things on which I worked, with Jonathan Rhoads, Cecelia Riegle, and Harry Vars built the
basis for the later work of Jonathan Rhoads, Stan Dudrick, and Doug Wilmore in their seminal work on total parenteral nutrition.
My comments about Philadelphia are an insider's comments, because TPN had its birth and early development in Philadelphia,
and I was on the one hand chiding and on the other hand encouraging other cities to do the same.
The paper is also interesting, because I also went into my early experiments, born of frustration in delivering parenteral
nutrition using everything from woven silk ueteral catheters to insulated radio wires from which the copper wire had been
removed in order to have a flexible tube to deliver parenteral nutrition. All these, of course, were in the days before polyethylene,
silastic and teflon.
I also go into the first polyethylene tube available and my own experience with it as well as the founding of the Supranant
Corp in Boston, the first manufacturer of polyethylene tubing for medicinal purposes.
The paper concludes with my six points learned from pioneering in getting ventilated dependant children back to their own
homes, and I point out how nicely those principles apply to home TPN, as well.
The paper is also a tribute to Keleen Burgess, a patient at the Children's Hospital of Philadelphia, who was the first
patient on TPN for a period of two years. The vision of her parents and their generosity of spirit are lauded, as are the
contributions that Keleen unconsciously made to the future of medicine and surgery in this field.