Nitrogen-sparing intravenous fluids in postoperative patients.
Improved nitrogen sparing was demonstrated in 20 patients undergoing either head-and-neck operations or abdominal explorations, who were randomized to receive intravenously either 3 per cent amino acids or 5 per cent dextrose. Infusions were started immediately after operation and continued for a minimum of six days. In patients receiving amino acids, as compared with those receiving dextrose, mean cumulative six-day nitrogen losses were significantly lower (42 plus or minus 5 g [S.E.M.] and 74 plus or minus 7 g, respectively--P smaller 0.005), as were serum glucose and insulin levels, but beta-hydroxybutyrate, acetoacetate and blood urea nitrogen were significantly elevated. No adverse effects of the amino acid solution were observed. The presumed mechanism for improved nitrogen sparing is a decrease in serum glucose and insulin levels, allowing greater endogenous fat mobilization and utilization, thus sparing lean body mass.
D000090:Acetoacetates / Q000097:blood; D000596:Amino Acids / Q000008:administration & dosage* / Q000378:metabolism; D001786:Blood Glucose / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D001806:Blood Urea Nitrogen; D004044:Dietary Proteins / Q000008:administration & dosage; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D006885:Hydroxybutyrates / Q000097:blood; D007263:Infusions, Parenteral; D007328:Insulin / Q000097:blood; D007657:Ketone Bodies / Q000097:blood; D008053:Lipid Mobilization; D009584:Nitrogen / Q000378:metabolism*; D010288:Parenteral Nutrition; D011182:Postoperative Care; D012996:Solutions; D013997:Time Factors
D000090:Acetoacetates; D000596:Amino Acids; D001786:Blood Glucose; D001798:Blood Proteins; D004044:Dietary Proteins; D006885:Hydroxybutyrates; D007328:Insulin; D007657:Ketone Bodies; D012996:Solutions; D005947:Glucose; D009584:Nitrogen