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Effect of Total Parenteral Nutrition with Xylitol on Protein and Energy Metabolism in Thermally Injured Rats

the Departments of Anesthesiology and Medical Biology, Knoxville Unit, University of Tennessee College of Medicine, The University of Tennessee Medical Center at Knoxville, Knoxville, Tennessee

Stephen J. Demichele, PH.D.

Nutrition/Metabolism Laboratory, Cancer Research Institute, New England Deaconess Hospital, Harvard Medical School, Boston, Massachusetts

Bruce R. Bistrian, M.D., PH.D.

Nutrition/Metabolism Laboratory, Cancer Research Institute, New England Deaconess Hospital, Harvard Medical School, Boston, Massachusetts

George L. Blackburn, M.D., PH.D.

Nutrition/Metabolism Laboratory, Cancer Research Institute, New England Deaconess Hospital, Harvard Medical School, Boston, Massachusetts

The use of xylitol as an alternative carbohydrate calorie source in total parenteral nutrition may offer unique pharmacologic and nutritional properties in the therapy of the thermally injured. Male Sprague-Dawley rats (250 g) received a 15-second dorsal scald injury (25-30% BSA) and were parenterally fed isovolemic diets (60 ml/day) that provided 200 kcal/kg/d, 9.68 g of amino acids/kg/d, and 23.5% nonprotein calories (NPC) as fat for 3 days. The balance of NPC were provided as dextrose (Dex) or 50% xylitol:50% dextrose (Xyl/ Dex). Rectus muscle and liver fractional protein synthetic rates (FSR, %/day), whole body leucine appearance (Flux), oxidation (OX), protein breakdown (PB), and synthesis (PS) were estimated using a 4-hour iv infusion of [1-¹⁴ C]leucine on day 3. Mean values (±SE) for leucine kinetics (µmol leucine/hr/100 g), cumulative nitrogen balance (mg N) and plasma insulin concentration (Table I). (µU/mL). The partial replacement of dextrose calories with xylitol did not significantly alter whole body and tissue leucine kinetics, daily and cumulative nitrogen balance, insulin concentration, and energy expenditure (indirect calorimetry). These data indicate that xylitol may be useful as an alternative carbohydrate calorie source in parenteral nutrition to avoid possible deleterious side effects of glucose overfeeding in the critically ill but did not improve protein metabolism under the conditions of this study. (Journal of Parenteral and Enteral Nutrition 15:445-449, 1991)

Journal of Parenteral and Enteral Nutrition, Vol. 15, No. 4, 445-449 (1991)
DOI: 10.1177/0148607191015004445


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