title: Controlled study of early postoperative parenteral nutrition in children.
abstract: OBJECTIVE
  Nutritional support of surgical patients has improved in recent years because of the possibility of modulating catabolism and anabolism, thus enhancing the immune response and repair processes. The objective of this study was to evaluate metabolic effects of early parenteral nutrition (PN) after major surgery.
  
  
  METHODS
  The authors studied 63 children aged 4 to 14 years with diffuse peritonitis caused by perforated-suppurative appendicitis. They were assigned randomly to a study group (SG, n = 31), which received PN for 5 days, starting 24 to 48 hours after surgery or to a control group (CG, n = 32), that received standard treatment (fluids). Weight, C-reactive protein (CRP), albumin, prealbumin, glycemia, nitrogen balance (NB), and insulinlike growth factor (IGF-I), were evaluated on postoperative days 1, 4, and 6.
  
  
  RESULTS
  Early nutritional support was associated with a significant improvement in NB and IGF-I (Repeat measures analysis of variance IGF-I, P<.001 and NB P<.01).
  
  
  CONCLUSIONS
  The authors conclude that early parenteral nutrition has a positive effect on the anabolic response as shown by improved NB and higher IGF-I levels in pediatric patients after major surgery.
authors.affiliation: INTA, University of Chile, Santiago.
authors.forename: V B
authors.initials: VB
authors.lastname: Marín
authors.forename: M G
authors.initials: MG
authors.lastname: Rebollo
authors.forename: C D
authors.initials: CD
authors.lastname: Castillo-Duran
authors.forename: M T
authors.initials: MT
authors.lastname: López
authors.forename: M S
authors.initials: MS
authors.lastname: Sanabria
authors.forename: F M
authors.initials: FM
authors.lastname: Moraga
authors.forename: F
authors.initials: F
authors.lastname: Castro
authors.forename: F Q
authors.initials: FQ
authors.lastname: Barrera
mesh_terms: D000293:Adolescent; D001064:Appendicitis / Q000150:complications; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D010288:Parenteral Nutrition; D010538:Peritonitis / Q000601:surgery*; D011182:Postoperative Care; D011184:Postoperative Period; D012709:Serum Albumin / Q000032:analysis
chemical_list: D012709:Serum Albumin; D007334:Insulin-Like Growth Factor I; D002097:C-Reactive Protein