Postoperative enteral hyperalimentation results in earlier elevation of serum branched-chain amino acid levels.
To objectively document the immediate maintenance and successful exploitation of postoperative gastrointestinal (GI) function, elemental diet was infused into the more distal duodenum of 30 cholecystectomy patients at 300 kcal per hour, beginning on arrival at the recovery room. Approximately 4,600 kcal and 190 grams of amino acids were absorbed during the initial 16 hours. Serum branched-chain amino acids (BCAAs) had risen above basal levels at 4 hours, statistically significant only for leucine (+64%). The higher concentrations had reached statistical significance for all BCAAs by 6 hours, when leucine had risen by 83%, isoleucine by 54%, and valine by 47%. The elevated BCAA and glucose levels sustained throughout the hyperalimentation period objectively verify that postoperative GI function can be safely exploited, and may contribute to improved wound healing and sepsis resistance.
Moss
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Department of Biomedical Engineering, Rensselaer Polytechnic Institute School of Engineering, Troy, New York 12180-3590.
Naylor
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D000597:Amino Acids, Branched-Chain / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D002763:Cholecystectomy; D004386:Duodenum; D002149:Energy Intake; D004750:Enteral Nutrition / Q000379:methods*; D005503:Food Additives / Q000627:therapeutic use; D005526:Food, Formulated; D005769:Gastrointestinal Motility; D006801:Humans; D017053:Infection Control; D007418:Intestinal Pseudo-Obstruction / Q000517:prevention & control; D009930:Organic Chemicals; D011182:Postoperative Care / Q000379:methods*; D013997:Time Factors; D014945:Wound Healing
D000597:Amino Acids, Branched-Chain; D001786:Blood Glucose; D005503:Food Additives; D009930:Organic Chemicals; C011567:Vivonex