ISSN:0148-6071    

DOI:10.1177/0148607189013004337

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

Amino acid uptake in skeletal muscle is reduced during different catabolic conditions such as sepsis, endotoxic shock, and uremia. The present study was designed to determine the effect of another catabolic condition, starvation, on amino acid transport in skeletal muscle. Male Sprague‐Dawley rats (40–60 g) were starved for 24, 48, or 72 hr and soleus (SOL) muscles were removed intact and incubated for 2 hr in a medium consisting of Krebs‐Henseleit bicarbonate buffer (pH 7.4) with glucose (5 mM), [14C]‐inulin, and [3H]‐α‐aminoisobutyric acid (AIB). Amino acid uptake was determined from intracellular to extracellular ratio of AIB following incubation. AIB uptake was significantly reduced after 24 hr of starvation and remained low with further fasting. After 72 hr the AIB distribution ratio was approximately 50% of initial value. Amino acid uptake returned to normal within 24 hr after refeeding of animals that had been starved for 72 hr. Plasma (0.25 ml) from starved rats, added to the incubation medium (2.75 ml) of muscles from nonfasted rats, significantly inhibited AIB uptake. The present results suggest that amino acid uptake in skeletal muscle is progressively reduced during starvation, an effect that may be mediated by a circulating factor(s) present in blood. (Journal of Parenteral and Enteral Nutrition13:344–348, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013004344

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

Sixty patients undergoing colorectal surgery for malignancy were randomized to receive the anabolic steroid stanozolol (n = 30) or to a control group (n = 30). Patients were further randomized to receive on the first 4 postoperative days a) a standard dextrose‐saline regimen (DS), b) an amino acid regimen (AA), or c) a glucose‐amino acid‐fat regimen (GAF) via a peripheral vein. Fat and carbohydrate oxidation rates were calculated pre‐ and postoperatively using indirect calorimetry. Postoperative nitrogen balance (NB) in patients receiving amino acids was significantly improved (p<0.02) by the administration of stanozolol. Fat and carbohydrate oxidation rates were not significantly affected by stanozolol. Patients in the stanozolol and control AA groups showed a fall in carbohydrate oxidation (p<0.01) and a rise in fat oxidation (p<0.05) postoperatively, whereas no significant changes in fat and carbohydrate oxidation occurred in the two DS and two GAF groups. Cumulative NB for the first 4 postoperative days was significantly better (p<0.01) in the two AA groups than in the two DS groups, due to an improved NB in the two AA groups on the 1st and 2nd days only. Cumulative NB in the two GAF groups was significantly better (p<0.01) than in all the other groups. This study shows that stanozolol improves postoperative NB in patients receiving amino acids alone, whereas the provision of a more complete nutritional regimen containing glucose, amino acids, and fat results in a positive NB unaffected by stanozolol. (Journal of Parenteral and Enteral Nutrition13:349–358, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013004349

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

Pentobarbital therapy has been associated with decreased urinary nitrogen excretion and resting energy expenditure in stressed patients. The metabolic effects of pentobarbital in sepsis were investigated in 29 well‐nourished rats who underwent superior vena caval cannulation, cecal ligation, and puncture. Animals were randomly assigned to receive either a continuous infusion of 20 mg/kg/day of pentobarbital combined with parenteral nutrition (n = 13) or parenteral nutrition alone (n = 16). Both groups received isocaloric, isonitrogenous parenteral nutrition postoperatively for 24 hr. Mean nitrogen balance (±SEM) was better in the pentobarbital group (+169 ± 76 mg/kg/dayus‐190 ± 66 mg/kg/day, p<0.01). No significant differences between the pentobarbital and control groups were noted for urinary 3‐methylhistidine excretion (9 ± 0.7 μg/kg/day us 11 ± 0.6 μg/kg/day, respectively) or 24 hr survival (77%vs69%, respectively). Pentobarbital improves nitrogen retention without decreasing urinary 3‐methylhistidine excretion in septic rats. (Journal of Parenteral and Enteral Nutrition13:359–361, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013004359

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

Eleven patients with severe refractory Crohns disease were treated with a high calorie, whole diet. Eight patients achieved remission with a drop in DAS from 13 to 4 (t= 6.31,p<0.001) and reversal of subacute obstruction in all cases. Nutritional parameters including weight, triceps skinfold thickness, arm muscle area, and serum albumin increased in all patients. The diet was well tolerated with a mean treatment period of 20 days. Clinical relapse of disease occurred in all cases within 9 months (mean 6 ± 2 months). The mechanism of action of a high calorie diet (HCD) is unclear and warrants further study but antigen or specific food exclusion does not appear to be required as judged by this study. (Journal of Parenteral and Enteral Nutrition13:362–365, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013004362

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

The effect of parenteral nutrition (PN), combined with corticosteroid therapy, on body composition was evaluated in 22 pediatric patients with active and complicated inflammatory bowel disease (IBD). The patients were divided into two groups according to the duration of PN. Group A consisted of 14 patients who received PN for an average of 43 days (short term) whereas eight patients received PN for an average of 104 days (long term); group B. Nutritional assessments were performed before and following the PN periods. In addition, a follow‐up assessment was performed 50 days after the cessation of PN for group A. Serial evaluations included; weight, height, disease activity score, arm anthropometry, sub‐scapular skinfold (SSSF) thickness, 24‐hr urinary creatinine, and computed tomography (CT) scan of the thigh. Following PN with a glucose‐fat mixture used as a nonprotein energy source, there were significant (p<0.05) increases in weight, SSSF, and muscle mass (MM) in both groups. Disease activity declined in both groups and height increased in group B and at the follow‐up assessment for group A. Considering extremity composition, both groups exhibited increases in midarm muscle area, midarm fat area, thigh muscle area, and thigh fat area. However, a differential distribution of incremental change was observed depending on the duration of PN. Fat deposition predominated in both the upper and lower extremities for group A. Group B patients, however, although showing a predominance of fat accumulation in the upper extremities, gained muscle and fat components equally in the lower extremities. The results indicate that the weight gain observed following the use of PN in patients with active and complicated IBD represents a deposition of muscle and fat at both whole body and extremity level and point out the importance of supplying glucose and fat as nonprotein energy sources in order to achieve better body composition. (Journal of Parenteral and Enteral Nutrition13:366–371, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013004366

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

In the records of our extensive metabolic studies on trauma victims, we found 16 head injured patients who had no other major injuries. Among them, nine had been given dexamethasone for at least 6 days. The other seven had not received any corticosteroids. There was no significant difference in the Glasgow Coma Scales of the treated and untreated groups. Metabolic balance studies were carried out for at least 3 days, including the periods when the treated patients were receiving dexamethasone. Mean nitrogen balance was ‐0.296 ± 0.03 g/kg/day for the treated group and ‐0.182 ± 0.03 g/kg/ day for the untreated group. This difference was significant (p= 0.02, t‐test). Our metabolic data are also consistent with those of other published studies, which used other corticosteroids and somewhat different methodologies. Thus, it is clearly established that corticosteroids cause significant degrees of catabolism in head injured patients, beyond what would “normally” be expected in such patients if they did not receive these drugs. (Journal of Parenteral and Enteral Nutrition13:372–376, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013004373

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

One hundred fourteen patients scheduled to undergo elective cholecystectomy were prospectively randomized into one of four treatment groups to study the potential benefits of esophagogastric decompression with and without immediate postoperative enteral nutrition. Group I was the control, and patients received only iv fluids and were allowed to eat as tolerated. Group II patients received iv fluids and esophagogastric decompression. Group III patients received esophagogastric decompression and enteral sterile water through the duodenal feeding lumen. Group IV patients received esophagogastric decompression and infusion of an elemental diet through the feeding lumen. The surgical techniques were standardized for all patients. The results of the study indicated no statistically or clinically significant differences among any of the treatment groups regarding; (1) need for parenteral analgesics or antiemetics, (2) tolerance of regular diet, (3) postoperative day of discharge, and (4) postoperative day that other discharge criteria were met. It is concluded that there is no objective benefit to the routine use of esophagogastric decompression with or without enteral nutrition in elective cholecystectomy patients. (Journal of Parenteral and Enteral Nutrition13:377–381, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013004377

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

The effects of alimentary whey proteins given, as whole proteins (WP), controlled trypsin and chymotrypsin hydrolysate oligopeptides (WPH), or a free amino acid mixture (AAM), on the growth, nitrogen retention, and steatorrhea were assessed in 24 Wistar rats (250 to 300 g) after 72 hr of starvation and 24 to 96 hr of realimentation and in 24 controls. The three diets had the same caloric, nitrogen, vitamin, and mineral contents. Rats had free access to the liquid diets. Only rats which ate the whole diet (90 cal) were included in the study. No differences in steatorrhea and fecal nitrogen were observed. The absorption rate was over 95% on the three diets. In contrast, weight gain was statistically better on WPH (+9% after 96 hr of realimentation) than on WP (+5%) or AAM (+2%). This was associated with a statistically higher nitrogen retention at all time periods studied, which was a result of a significant lower nitrogen urinary excretion. Similar results were obtained in controls. This better growth was a result of a better protein synthesis and lower ureagenesis. (Journal of Parenteral and Enteral Nutrition13:382–386, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013004382

出版商:SAGE Publications    

年代:1989

数据来源: WILEY

摘要:

During a 6‐week period, all adult patients in a university hospital receiving ready‐to‐feed nasoenteric tube feeding formula were prospectively studied. The study objective was to determine each patient's caloric intake from tube feeding relative to their energy needs and to identify factors causing decreased feeding intake. Each of 35 patients was visited at least once daily to determine their volumetric intake of tube feeding formula. Daily review of patient care records and nursing interviews were used to identify interruptions in therapy. Patient's basal energy expenditures (BEE) were calculated using the Harris‐Benedict equation. Calorie goals were set by members of the Nutrition Support Service or clinical dietitians. Intakes averaged 1095 ± 41 Kcal (SEM) per day or 61% of their mean calorie goal of 1791 ± 41 Kcal. Mean daily calorie intake was statistically different (p<0.05) from mean energy goal on patient study days 1 through 5, 7, and 8. Only 16 of the 35 patients achieved an intake of 100% of their energy goal on any day of therapy. Calorie goals averaged 1.4 times BEE. Mean daily calorie intake did not exceed BEE until study day 10. Eighteen % of potential feeding time was lost due to temporary feeding interruptions; primarily inadvertent extubation (4.6%), gastrointestinal intolerance (4.7%), medical procedures requiring discontinuation of feeding (2.8%), and feeding tube positioning difficulties (1.5%). In addition, physicians ordered only 75% of calculated energy goals. These data indicate that tube feeding therapy, when provided under usual hospital conditions, does not meet patient's energy requirements. (Journal of Parenteral and Enteral Nutrition13:387–391, 1989)

ISSN:0148-6071    

DOI:10.1177/0148607189013004387

出版商:SAGE Publications    

年代:1989

数据来源: WILEY