Abstract
Thirteen obese patients requiring parenteral nutrition for postoperative complications were studied prospectively to evaluate the efficacy of hypocaloric, high-protein parenteral feeding. Nonprotein caloric intake averaged 881 kcal/d or 51.5% of the patients' measured resting energy expenditure. Protein averaged 2.13 ± 0.59 g/kg ideal body weight (IBW). Serum albumin and TIBC increased significantly (2.8 ± 0.5 g/dL to 3.2± 0.4 g/dL, p < .01 and 196 ±39 μg/dL to 248 + 49μ g/dL, p < .05, respectively), and subjects lost weight (120.0± 60.0 kg to 109.7 ±32.5 kg, p < .05). Nitrogen balance studies in 8 subjects suggested nitrogen equilibrium or positive balance can be achieved (+2.4 ± 1.9 g/dL). All patients exhibited complete tissue healing of wounds and abscess cavities and closure of fistulae. In obese, protein-depleted surgical patients, net protein anabolism and clinical efficacy can be achieved with hypocaloric, high-protein feeding. Abundant endogenous fat stores provide obligatory energy. (Dickerson RN, Rosato, E, Mullen JL. New protein anabolism with hypocaloric parenteral nutrition in obese stressed patients.
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