Randomized controlled study of glycerol versus dextrose in postoperative hypocaloric peripheral parenteral nutrition.
The aim of this study was to use glycerol and dextrose in hypocaloric peripheral parenteral nutrition (HPNN) and investigate their effects on postoperative metabolic and nutritional responses. Thirty patients who had undergone major gastrointestinal surgery were examined in a prospective randomized study. The study period extended from the day before operation to postoperative day 7. Fifteen patients (intervention group) received 1.2 g amino acids, 1.2 g glycerol, and 0.5 g fat emulsion/kg/day (approximately 15 kcal/kg/day). The other 15 patients (control group) received 1.2 g amino acids, 1.5 g dextrose, and 0.5 g fat emulsion/kg/day (approximately 15 kcal/kg/day). After 7 days of study, both groups were found to have a decrease in body weight, mid-arm circumference, triceps skin fold, serum albumin, and transferrin and prealbumin levels, but an increase in serum cholesterol and triglyceride levels. However, the differences between them were not significant. Improvements in nitrogen balance were observed in the intervention group (p = .035). These data suggest that advantages favoring the administration of glycerol instead of dextrose in hypocaloric parenteral nutrition could hardly be found in our investigation, except that better nitrogen equilibrium is maintained. Nonetheless, the peripheral intravenously administered ProcalAmine with fat emulsion has been well tolerated and safe for these patients, as well as more convenient for clinical use.
Sun
Li-Chu
LC
Nutrition Service Team, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Shih
Ying-Ling
YL
Lu
Chien-Yu
CY
Chen
Fang-Ming
FM
Hsieh
Jan-Sing
JS
Chuang
Jui-Fen
JF
Wang
Jaw-Yuan
JY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000008:administration & dosage / Q000009:adverse effects; D013505:Digestive System Surgical Procedures; D004311:Double-Blind Method; D004573:Electrolytes / Q000008:administration & dosage / Q000009:adverse effects; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005947:Glucose / Q000008:administration & dosage* / Q000009:adverse effects; D005990:Glycerol / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism; D010288:Parenteral Nutrition / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies
D000596:Amino Acids; D004573:Electrolytes; D005217:Fat Emulsions, Intravenous; C052903:ProcalAmine; D005947:Glucose; D009584:Nitrogen; D005990:Glycerol