The metabolic effects of isotonic amino acid infusion in surgical sepsis.
28 normally nourished adult male and female patients who had undergone major elective surgery were maintained on dextrose-free isotonic amino acid solutions as their sole nutritional support. In the 6 days after surgery, 15 patients had no septic complications, 9 developed superficial sepsis, and 4 developed a deep seated collection of pus or deep sepsis. Patients without infection developed and maintained a fasting metabolic fuel profile within the first 3 days and increasingly spared protein. Superficial sepsis caused a small depression in serum ketone body concentrations but did not otherwise alter the fasting profile. Moreover nitrogen balances and plasma albumin and transferrin concentrations were unaltered by superficial sepsis which is not the response usually recognised with infection. Metabolic adaptation to the fasting state was lost in patients with deep sepsis and nitrogen losses were increased with greater decreases in plasma albumin and transferrin.
Miller
J D
JD
Department of Surgery, University of Aberdeen, Foresterhill, Aberdeen UK.
Broom
J
J
Smith
G
G