title: Glucose balance and muscle glycogen during TPN in the early post-operative phase.
abstract: In order to study how muscle glycogen is influenced by different nutritional regimens in the early post-operative period we took muscle biopsies from 20 patients preoperatively and on the fourth post-operative day after abdominal aortic surgery. Ten patients received 93% of non-protein energy as glucose, 7% as fat (Intralipid) and insulin was given to keep the blood glucose below 10 mmol/l. The remaining patients had 80% of non-protein energy as fat (Intralipid). Amino acids constituting 12 g of nitrogen daily were given to both groups. Daily measurements of gas exchange (oxygen uptake, CO2-production) were performed and from these data glucose balance was calculated as the difference between glucose intake and glucose expenditure. Muscle biopsies were analysed for glycogen, adenosine triphosphate, glucose-6-phosphate, lactate and citrate. We found that it was possible to maintain muscle glycogen stores at pre-operative levels with a glucose-insulin regimen. With the fat regimen there was a 31% decrease in muscle glycogen and two patients had a negative glucose balance despite the fact that 150 g of glucose were given. Average glucose balance throughout the study correlated positively with glucose intake. A significant correlation between glucose on the third day and change in muscle glycogen content was found. Muscle content of adenosine triphosphate, glucose-6-phosphate, lactate and citrate were similar in both groups.
authors.affiliation: Department of Anaesthesiology, Uppsala University, Akademiska sjukhuset, S-751 85 Uppsala, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Henneberg
authors.forename: H
authors.initials: H
authors.lastname: Stjernström
authors.forename: B
authors.initials: B
authors.lastname: Essén-Gustavsson
authors.forename: L
authors.initials: L
authors.lastname: Wiklund