|
Sign In to gain access to subscriptions and/or personal tools.
|
Intravenous Protein-sparing Therapy in Patients with Gastrointestinal Disease
Gordon R. Greenberg, M.D.
Clinical Science Division, Department of Medicine, University of Toronto, Toronto, Canada
Khursheed N. Jeejeebhoy, M.D.
Clinical Science Division, Department of Medicine, University of Toronto, Toronto, Canada
Two groups (each of 6 moderately ill, protein-depleted patients) were infused daily for 7 days. Mean 7 day nitrogen (N) balances with infusions of 0.83 and 1.83 g of a defined amino acid mixture (containing further nutrients but no other source of energy)/kg ideal body wt/day were –3.66 and +1.54 g/day, respectively (P < 0.025) when adjusted for changes in body urea and estimated miscellaneous N losses. Concentrations of plasma free fatty acids, immunoreactive insulin and glucagon, and of blood glucose, pyruvate, lactate and glycerol were indistinguishable on corresponding treatment days in the 2 groups but blood ketone bodies were lower in the 1.83 g/kg group. Blood amino acid concentrations of alanine, valine, leucine, and isoleucine were similar, whereas those of phenylalanine, histidine, serine, and arginine were higher, and glutamine lower, in the 1.83 g/kg group. The data confirm that not only can body protein mass be maintained, but a net positive N retention achieved, in such patients, through provision of exogenous amino acids and concurrent mobilization of endogenous energy stores. Of note is that this fat mobilization can occur without plasma free fatty acids and/or significant blood ketone body elevations. An infusion of 2, rather than 1 g/kg/day seems suitable in the situation examined.
Journal of Parenteral and Enteral Nutrition, Vol. 3, No. 6,
427-432 (1979)
DOI: 10.1177/014860717900300605
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
J. A. Palesty and S. J. Dudrick
The Goldilocks Paradigm of Starvation and Refeeding
Nutr Clin Pract,
April 1, 2006;
21(2):
147 - 154.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. S. Choban and R. N. Dickerson
Morbid Obesity and Nutrition Support: Is Bigger Different?
Nutr Clin Pract,
August 1, 2005;
20(4):
480 - 487.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. N. Jeejeebhoy
Permissive Underfeeding of the Critically Ill Patient
Nutr Clin Pract,
October 1, 2004;
19(5):
477 - 480.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L J. Hoffer
Protein and energy provision in critical illness
Am. J. Clinical Nutrition,
November 1, 2003;
78(5):
906 - 911.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. L. Macias, K. J. Alaka, M. H. Murphy, M. E. Miller, W. R. Clark, and B. A. Mueller
Impact of the Nutritional Regimen on Protein Catabolism and Nitrogen Balance in Patients With Acute Renal Failure
JPEN J Parenter Enteral Nutr,
January 1, 1996;
20(1):
56 - 62.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. Phinney
Energy Expenditure and the Critically Ill
JPEN J Parenter Enteral Nutr,
September 1, 1995;
19(5):
426 - 427.
[PDF]
|
|
|
|
|
|
|
D. Mcr. Russell, H. L. Atwood, and K. N. Jeejeebhoy
Nitrogen versus Muscle Calcium in the Genesis of Abnormal Muscle Function in Malnutrition
JPEN J Parenter Enteral Nutr,
July 1, 1985;
9(4):
415 - 421.
[PDF]
|
|
|
|
|
|
|
M.J. Ostro, G.R. Greenberg, and K.N. Jeejeebhoy
Total Parenteral Nutrition and Complete Bowel Rest in the Management of Crohn's Disease
JPEN J Parenter Enteral Nutr,
May 1, 1985;
9(3):
280 - 287.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. SHIKE, D. McR. RUSSELL, A. S. DETSKY, J. E. HARRISON, K. G. McNEILL, F. A. SHEPHERD, R. FELD, W. K. EVANS, and K. N. JEEJEEBHOY
Changes in Body Composition in Patients with Small-Cell Lung Cancer: The Effect of Total Parenteral Nutrition as an Adjunct to Chemotherapy
Ann Intern Med,
September 1, 1984;
101(3):
303 - 309.
[Abstract]
[PDF]
|
|
|
|
|
