This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Messing, B. Articles by Bernier, J.J. Search for Related Content PubMed PubMed Citation Articles by Messing, B. Articles by Bernier, J.J. Social Bookmarking                         What's this?

Metabolic Study during Cyclic Total Parenteral Nutrition in Adult Patients with and without Corticosteroid-induced Hypercatabolism: Comparison with Standard Total Parenteral Nutrition

Research Unit on Pathophysiology of Digestion, Inserm U54, Hôpital Saint-Lazare, 107 rue du faubourg Saint-Denis, 75475 Paris Cedex 10, France

P.J. Pontal, M.D.

Research Unit on Pathophysiology of Digestion, Inserm U54, Hôpital Saint-Lazare, 107 rue du faubourg Saint-Denis, 75475 Paris Cedex 10, France

J.J. Bernier, M.D.

Research Unit on Pathophysiology of Digestion, Inserm U54, Hôpital Saint-Lazare, 107 rue du faubourg Saint-Denis, 75475 Paris Cedex 10, France

In order to assess the metabolic efficacy of cyclic nocturnal parenteral nutrition (C-TPN) in hospitalized patients, a prospective study was carried out with 14 patients having a protein calorie malnutrition due to severe gastrointestinal diseases. Patients population was divided into two groups: one group received 1 milligram per kilogram per day of prednisolone with induced hypercatabolism (n = 4); the second group was not under corticosteroid therapy (n = 10). Patients selected for the study were unaffected by cardiac, hepatic, renal or pulmonary failure, diabetes or bacteriemia. C-TPN was compared to standard or continuous TPN (S-TPN) and each type of TPN was 1 week with 24 hours between change over. During C-TPN, parenteral perfusion was discontinued for 9.1 ± 0.4 hours per day (mean ± SEM). Intravenous regimens were strictly the same during C-TPN and S-TPN and provided 192 ± 10 milligram nitrogen per kilogram per day plus mixed energy-sources equivalent to 50 ± 2 kilocalories per kilogram per day with a glucose-fat emulsion ratio of 50 ± 5%. Metabolic data for each period included weight, serum albumin and transferrin changes, protein breakdown as estimated by measurement of urea production rate and lean body mass gain estimated from determination of total nitrogen balance. In corticosteroid-induced hypercatabolic patients, C-TPN provides visceral protein gain equal to S-TPN and halves the water-energy deposits observed during S-TPN, but is less effective than S-TPN for decreasing protein breakdown and achieving lean body mass gain. Inversely, in mildly catabolic patients, C-TPN provides visceral protein and lean body mass gains which are similar to those achieved with S-TPN; C-TPN, however, halves the water-energy deposits when compared to S-TPN. From these data, C-TPN can be proposed as an optimal therapy in mildly or uncatabolic patients who do not have severe energy depletion.

Journal of Parenteral and Enteral Nutrition, Vol. 7, No. 1, 21-25 (1983)
DOI: 10.1177/014860718300700121


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A. Hyltander Invited Review: Intravenous Feeding Kinetics and Its Effects on Energy and Nitrogen Metabolism Nutr Clin Pract, April 1, 1994; 9(2): 51 - 57. [Abstract] [PDF]

				E. Lerebours, A. Rimbert, B. Hecketsweiler, M.-F. Hellot, P. Denis, and R. Colin Comparison of the Effects of Continuous and Cyclic Nocturnal Parenteral Nutrition on Energy Expenditure and Protein Metabolism JPEN J Parenter Enteral Nutr, July 1, 1988; 12(4): 360 - 364. [Abstract] [PDF]

				F. W. Nugent, M. Rajala, R. A. O'Shea, P. F. Kolack, M. A. Hobin, M. K. Haimes, and M. L. Ingalls Total Parenteral Nutrition in Pregnancy: Conception to Delivery JPEN J Parenter Enteral Nutr, July 1, 1987; 11(4): 424 - 427. [Abstract] [PDF]