title: Body composition studies with intravenous nutrition.
abstract: Intravenous nutrition is a complex nutritional support system which is used for patients who are unable to take food through the normal enteric route. The nutritional protocols are complex and the patients being studies have many complicating factors which make determination of outcome difficult to measure. Body composition measures have proven to be very accurate in determining appropriate protocols for patient care. Because most of the patients being studied have a short term nutritional problem, appropriate period of study was found to be two weeks. In this model we have been able to consistently measure small changes in groups of between 10-15 patients. A large change which may occur in a more severe case could be demonstrated in simple patients. This model has demonstrated that 0.3 g of nitrogen per kg per day and 40 kcal of energy are necessary to maintain body composition over a 14 day period. This nutritional input appeared to be similar whether the patient was in the post-operative non septic state or in the pre-operative depleted condition. Studies were undertaken to show that nutritional benefit of changing from all-glucose to a lipid containing solution did not affect the nutritional outcome of therapy. The nutritional gains seen over the first 14 day period were sustained in a longer study of a small group of patients who were studied at two weekly intervals for 3 months. Subsequent to these studies it has been considered important to determine whether peripheral intravenous nutrition would be as effective as central intravenous nutrition. By adjusting the nutritional protocol such that it fulfilled the rules obtained by central intravenous studies we have demonstrated that peripheral iv nutrition can maintain body composition but that the amount of glucose required for this to occur is at least 30% of non-protein calories.
authors.affiliation: University Department of Surgery, Royal North Shore Hospital, St Leonards, NSW, Australia.
authors.forename: R C
authors.initials: RC
authors.lastname: Smith