Muscle protein synthesis after operation: effects of intravenous nutrition.
OBJECTIVE
To assess the effect of an elective abdominal surgical operation (open cholecystectomy) on the rate of protein synthesis in skeletal muscle in humans.


METHODS
Prospective random control trial.


METHODS
University hospital.


METHODS
17 Metabolically healthy patients who were to undergo elective open cholecystectomy.


METHODS
Patients randomised to receive either saline alone (n = 8) or total parenteral nutrition (n = 9) for three days after operation. The rate of protein synthesis in muscle was calculated from the increase in enrichment of (1-13C) leucine in protein after a flooding dose of (1-13C) leucine.


RESULTS
Median (quartiles) rate of protein synthesis had decreased on the third postoperative day in the saline group by 49% (from 2.42 [2.03, 2.54] to 1.24 [0.99, 1.63]) and in the group that had received total parenteral nutrition by 54% (from 1.96 [1.90, 2.07] to 0.91 [0.79, 1.06]) (p < 0.01).


CONCLUSIONS
The trauma associated with open cholecystectomy reduced the rate of protein synthesis in skeletal muscle by half in three days, and conventional total parenteral nutrition had no effect on these changes.
Essén
P
P
Department of Anesthesiology, Huddinge University Hospital, Stockholm, Sweden.
McNurlan
M A
MA
Sonnenfeld
T
T
Milne
E
E
Vinnars
E
E
Wernerman
J
J
Garlick
P J
PJ
D000328:Adult; D001786:Blood Glucose; D002763:Cholecystectomy; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D008297:Male; D009124:Muscle Proteins / Q000096:biosynthesis*; D009584:Nitrogen / Q000652:urine; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies
D001786:Blood Glucose; D007328:Insulin; D009124:Muscle Proteins; D009584:Nitrogen