Related Experiment Videos
Controlled study of early postoperative parenteral nutrition in children
V B Marín1, M G Rebollo, C D Castillo-Duran
1INTA, University of Chile, Santiago.
Insights
Early parenteral nutrition (PN) in pediatric surgical patients significantly improved nitrogen balance and insulin-like growth factor 1 (IGF-I) levels. This early nutritional support enhances anabolic response and recovery after major surgery.
Area of Science:
- Pediatric Surgery
- Nutritional Support
- Metabolic Response
Background:
- Recent advancements allow modulation of catabolism and anabolism in surgical patients.
- Nutritional support can enhance immune response and tissue repair processes.
Purpose of the Study:
- To evaluate the metabolic effects of early parenteral nutrition (PN) in pediatric patients following major surgery.
Main Methods:
- 63 children (4-14 years) with perforated-suppurative appendicitis were randomized.
- Study group (n=31) received PN for 5 days starting 24-48h post-op.
- Control group (n=32) received standard fluid therapy. Parameters measured: weight, CRP, albumin, prealbumin, glycemia, nitrogen balance (NB), and IGF-I on days 1, 4, and 6.
Main Results:
- Early PN significantly improved nitrogen balance (NB) (P<.01).
- Early PN led to a significant increase in insulin-like growth factor 1 (IGF-I) levels (P<.001).
Conclusions:
- Early parenteral nutrition positively impacts the anabolic response in pediatric surgical patients.
- Improved NB and higher IGF-I levels indicate enhanced recovery with early PN.
Background/Purpose:
Nutritional support of surgical patients has improved in recent years because of the possibility of modulating catabolism and anabolism, thus enhancing the immune response and repair processes. The objective of this study was to evaluate metabolic effects of early parenteral nutrition (PN) after major surgery.
Methods:
The authors studied 63 children aged 4 to 14 years with diffuse peritonitis caused by perforated-suppurative appendicitis. They were assigned randomly to a study group (SG, n = 31), which received PN for 5 days, starting 24 to 48 hours after surgery or to a control group (CG, n = 32), that received standard treatment (fluids). Weight, C-reactive protein (CRP), albumin, prealbumin, glycemia, nitrogen balance (NB), and insulinlike growth factor (IGF-I), were evaluated on postoperative days 1, 4, and 6.
Results:
Early nutritional support was associated with a significant improvement in NB and IGF-I (Repeat measures analysis of variance IGF-I, P<.001 and NB P<.01).
Conclusions:
The authors conclude that early parenteral nutrition has a positive effect on the anabolic response as shown by improved NB and higher IGF-I levels in pediatric patients after major surgery.