title: Reducing parenteral energy and protein intake improves metabolic homeostasis after bone marrow transplantation.
abstract: The purpose of this prospective study was to compare the metabolic effects of reducing parenteral energy and protein intake in bone-marrow-transplant (BMT) patients from 150% (hi-TPN group) to 100% (lo-TPN group) basal energy expenditure. Cytotoxic therapy was given on days 1-5, BMT on day 6, and TPN beginning on days 6 or 7. The lo-TPN group exhibited higher serum albumin (38 +/- 0.4 vs 32 +/- 0.4 g/L, P less than 0.01) but similar nitrogen balance (-83 +/- 8 vs -86 +/- 8 mg.kg-1.d-1, P greater than 0.05). Serum Na+ remained greater than 134 +/- 1 mmol/L in the lo-TPN group but fell to 127 +/- 1 mmol/L in the hi-TPN group (P less than 0.001) despite similar Na+ intakes and balances. Serum K+ remained less than 4.4 +/- 0.2 mmol/L in the lo-TPN group but rose to 5.1 +/- 0.1 mmol/L in the hi-TPN group (P less than 0.01) despite similar K+ intakes and balances. Delivering TPN at lower-than-normal rates after BMT appears to minimize Na+ and K+ disturbances and improve serum albumin concentrations without having any adverse effect on nitrogen balance.
authors.affiliation: Department of Medicine, Montreal General Hospital, Quebec, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Taveroff
authors.forename: A H
authors.initials: AH
authors.lastname: McArdle
authors.forename: W B
authors.initials: WB
authors.lastname: Rybka
mesh_terms: D000704:Analysis of Variance; D001835:Body Weight; D016026:Bone Marrow Transplantation; D004044:Dietary Proteins / Q000494:pharmacology*; D002149:Energy Intake; D006706:Homeostasis; D006801:Humans; D010289:Parenteral Nutrition, Total; D011184:Postoperative Period; D011188:Potassium / Q000097:blood; D012709:Serum Albumin / Q000032:analysis; D012964:Sodium / Q000097:blood; D014508:Urea / Q000652:urine
chemical_list: D004044:Dietary Proteins; D012709:Serum Albumin; D014508:Urea; D012964:Sodium; D011188:Potassium