Controlled study of early postoperative parenteral nutrition in children.
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.
Marín
V B
VB
INTA, University of Chile, Santiago.
Rebollo
M G
MG
Castillo-Duran
C D
CD
López
M T
MT
Sanabria
M S
MS
Moraga
F M
FM
Castro
F
F
Barrera
F Q
FQ
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
D012709:Serum Albumin; D007334:Insulin-Like Growth Factor I; D002097:C-Reactive Protein