Active Metabolic Expenditure of Gastroenterological Surgical Patients Receiving Intravenous Nutrition

Abstract

The active metabolic expenditure of 30 gastroenterological surgical patients was measured by performing an energy balance study over 14 days of intravenous nutrition. The mean value of active metabolic expenditure in preoperative patients (559 ± 384 kcal/day) was significantly higher (p < 0.02) than postoperative patients (245 ± 325 kcal/day) but there was wide individual variation within both groups. Combinations of these results with values of resting metabolic expenditure obtained in the same patients suggest that very few uncomplicated surgical patients will ever require more than 2000 kcal/day to achieve a positive energy balance. (Journal of Parenteral and Enteral Nutrition 8:371-376, 1984)

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References

Duke JH Parenteral nutrition. IN The manual of Surgical Nutrition, Ballinger WF , Collins JA , Drucker (ed). WB Saunders, Philadelphia, 1975, pp 285-317

Macfie J. , Holmfield J. , King Rfgj , et al: The effect of gastrointestinal malignancy on resting metabolic expenditure. Br J Surg 69:443-447, 1982

Zuntz N. , Schumberg L. : Studien zu einer Physiologie des Marches. Berlin , 1901

Gump FE , Martin P. , Kinney JM : Oxygen consumption and calorie expenditure in surgical patients. Surg Gynecol Obstet 137:499-513, 1973

Kinney JM , Zarem HA , Rogers RC : Energy expenditure and utilisation of carbohydrate, fat and protein in hospitalised patients. Quoted by Gump FE, et al. Surg Gynecol Obstet 137:499-513, 1973

Hill GL , McCarthy ID , Collins JP , et al: A new method for the rapid measurement of body composition in critically ill surgical patients. Br J Surg 86:732-735, 1978

King Rfgj , Macfie J. , Hill GL : The effect of intravenous nutrition with glucose as the only calorie source on muscle glycogen. JPEN 5:226-229, 1981

Hultman E. , Bergstrom J. , Roch-Norlund AE : Glycogen storage in human skeletal muscle. IN Muscle Metabolism during Exercise , Pernow B , Saltin B (eds). Plenum Press, New York, 1971, pp 273-288

Hultman E. Nilsson LH : Liver glycogen in man. Effect of different diets and muscular exercise. IN Muscle Metabolism during Exercise, Pernow B , Saltin B (eds). Plenum Press, New York, 1971 pp 143-151

10.

Kinney JM , Long CL , Gump FE et al: Tissue composition of weight loss in surgical patients. Ann Surg 168:459-474, 1968

11.

Tweedle D. , Johnston IDA. Factors affecting the metabolic expenditure of surgical patients. Br J Surg 58:771-774, 1971

12.

Rutten P. , Blackburn GK , Flatt JP , et al: Determination of optimal hyperalimentation infusion rate. J Surg Res 18:477-483, 1975

13.

Gazzaniga AB , Polachek JR , Wilson AF , et al: Indirect calorimetry as a guide to calorie replacement during total parenteral nutrition. Am J Surg 136:128-133, 1978

14.

Kinney JM : Energy requirements for parenteral nutrition. IN Total Parenteral Nutrition . Fisher JE (ed). Little Brown & Co., Boston, 1976, pp 135-142

15.

Shizgal HM : The use of body composition measurements to assess the efficacy of parenteral nutrition. IN Advances in parenteral nutrition, Johnston IDA (ed). MTP Press Ltd. , Lancaster , England, 1970, pp 535-556

16.

Smith RC , Burkinshaw L. , Hill GL : Optimum energy and nitrogen intake for gastroenterological patients requiring intravenous nutrition. Gastroenterology 82:445-452, 1982