title: What energy level is required to avoid nutrient depletion after surgery in oropharyngeal cancer?
abstract: The rate of energy expenditure was repeatedly measured by indirect calorimetry both in the basal state (BMR) and in the resting fed state (RMR) in 8 middle-aged male patients operated for oropharyngeal cancer. In the postsurgical phase, two sequential energy levels were administered by nasogastric tube: (1) a 'maintenance' level (days 3-5) at 1.4 X measured presurgery BMR; (2) a 'supramaintenance' level (days 6-9) at 1.7 X measured BMR on day 6. Before surgery the patients had a BMR averaging (23.7 +/- 1.0 kcal/kg.day). After surgery BMR increased to 27.6 +/- 2.7 kcal/kg.day (day 6), then it decreased to 24.4 +/- 1.4 kcal/kg.day (day 10). The difference between RMR and BMR yielded a nutrient-induced thermogenesis averaging 5 +/- 1 and 8.5 +/- 2% (p less than 0.05) on levels 1 and 2, respectively. It is concluded that an energy level corresponding to 1.4 X presurgery BMR is sufficient to maintain energy and substrate equilibrium in nondepleted patients, whereas 1.7 X BMR induces positive protein and fat balances concomitant to a decrease efficiency of energy utilization.
mesh_terms: D000328:Adult; D001798:Blood Proteins / Q000378:metabolism; D002153:Calorimetry, Indirect; D002784:Cholesterol / Q000097:blood; D004032:Diet; D004734:Energy Metabolism; D004750:Enteral Nutrition; D006801:Humans; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000517:prevention & control*; D009959:Oropharyngeal Neoplasms / Q000378:metabolism* / Q000601:surgery / Q000628:therapy; D010610:Pharyngeal Neoplasms / Q000378:metabolism*; D011182:Postoperative Care; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D001798:Blood Proteins; D012709:Serum Albumin; D002784:Cholesterol