Medicine: Life Jacket

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Dudrick set out to overcome the problem in another way. He reasoned that if he could put all the needed nutrients directly into the blood, he could bypass the entire gastrointestinal tract, including the mouth, esophagus, stomach, duodenum, jejunum, ileum and colon. But what combination and concentration of chemicals to use? And how to deliver the chemical soup? Dudrick knew he needed a concentrated mixture of sugar for energy and amino acids for growth and development, as well as fats, vitamins, minerals and trace elements. But he was also aware that the necessarily high concentration of substances introduced at one point in the circulatory system could damage blood vessels or cause blood clots. His solution: infusing the nutrients into the superior vena cava because the vessel's large blood flow dilutes the mixture rapidly. In 1966 Dudrick tried the technique on six "terminally ill" patients. All survived their immediate illnesses and four are still alive.

Since that initial success, Dudrick has treated more than 6,000 patients. Most required only temporary hyperalimentation while they recovered from illness, surgery, the effects of cancer therapy or severe burns. In some cases of severe inflammatory bowel disease, intravenous feeding has given the bowel a rest and a chance to heal itself, thus eliminating the need for surgery. All of Dudrick's patients receive solutions tailor-made to their individual needs; some contain as many as 60 substances. An adult generally receives three liters a day, each liter supplying about 1,000 calories.

Despite widespread awareness of intravenous hyperalimentation, only 5% to 10% of hospitals actually use the technique regularly. Still, Dudrick is encouraged. Says he: "Physicians are less and less resistant to hyperalimentation, and any hospital today can muster people capable of doing this. It's so simple it's almost embarrassing."