Perioperative nutrition prevents the early protein losses in patients submitted to gastrointestinal surgery.
OBJECTIVE
The metabolic response to surgery includes a net loss of proteins that influences negatively the clinical evolution of the patients. We investigated the effect of perioperative nutrition on protein metabolism alterations immediately after surgery.


METHODS
A control group of 21 surgery patients were submitted to conventional perioperative nutritional protocol (18 h of fasting plus low-dose glucose after surgery). An experimental group of eight similar patients was given complete parenteral nutrition during 24 h before and 24 h after surgery. Nitrogen balance, whole body protein synthesis, breakdown, and 3-methylhistidine were determined before surgery and 24 h after surgery.


RESULTS
The immediate response to surgery with conventional nutritional management was a net protein loss (-1.023 g prot. kg(-1) day(-1)), caused by an increase in the protein breakdown (137.9% of preoperative values), while the protein synthesis remained unchanged (98.4%). The 3-methylhistidine excretion was not increased in respect to perioperative values, suggesting that the degraded protein was not from muscular origin. The experimental group with perioperative nutrition showed neither protein loss (+0.075 g prot. kg(-1) day(-1)) nor changes in protein synthesis or breakdown vs. preoperative values (96.3% and 88.0%, respectively).


CONCLUSIONS
Perioperative nutrition prevents the early protein losses after gastrointestinal surgery.
López-Hellín
Joan
J
Centre d'Investigacions en Bioquímica i Biologia Molecular, pta. 14, area materno-infantil, Hospitals Vall d'Hebron, P. Vall d'Hebron, 119-129, 08035-Barcelona, Spain. joalopez@vhebron.net
Baena-Fustegueras
Juan Antonio
JA
Vidal
Montse
M
Riera
Simón Schwartz
SS
García-Arumí
Elena
E
D005215:Fasting; D005260:Female; D041981:Gastrointestinal Tract / Q000601:surgery; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008762:Methylhistidines / Q000652:urine; D008875:Middle Aged; D009124:Muscle Proteins / Q000378:metabolism; D009584:Nitrogen / Q000378:metabolism*; D010289:Parenteral Nutrition, Total; D019990:Perioperative Care / Q000379:methods*; D011184:Postoperative Period; D011506:Proteins / Q000378:metabolism*
D008762:Methylhistidines; D009124:Muscle Proteins; D011506:Proteins; D005947:Glucose; C028118:3-methylhistidine; D009584:Nitrogen