Nutritional modulation of protein metabolism after gastrointestinal surgery

摘要: The metabolic response to surgery includes alterations in protein metabolism, resulting a net loss of proteins. Protein hypercatabolism is considered an unavoidable consequence injury, and important source morbidity mortality. Our purpose was determine the effect nutrition on metabolism following gastrointestinal surgery, elucidate whether postoperative can be prevented with adequate nutritional support. Patients who had undergone were given four different parenteral nutritions increasing glucose, lipid amino acid content during 7 days surgery. Nitrogen balance, synthesis breakdown determined using vivo stable isotope labelling. Other metabolites (3-methylhistidine, creatinine, urea, cortisol, insulin, acids C-reactive protein) measured. A nutrition-dependent alteration found surgical injury. Nutrition modified nitrogen whole-body and, lesser extent, muscle breakdown. low-energy without produced negative balance (postoperative day 7=−0.381 g protein kg−1day−1) that did not normalize study period (day synthesis=239% 217% vs preoperative). receiving two low energy containing less 7=−0.011 −0.133 g transient increase metabolism. complete maintained, all studied days, parameters within preoperative reference range (synthesis 2=92%, 4=110% 7=79%; 2=85%, 4=80%, 7=76% preoperative) positive 2=+0.0387, 4=+0.578 7=+0.227 g protein kg−1day−1). Complete support prevent after maintain alterations.