Fructose-1,6-diphosphate-added total parenteral nutrition in septic animals and stressed patients

To investigate the roles of fructose-1,6-diphosphate (FDP)-added total parenteral nutrition (TPN) in septic animals and stressed patients.

Thirteen adult dogs were randomly assigned to one of two study groups 6 hours after the induction of severe intra-abdominal infection. Group TPN (n = 6) received 70 kcal.kg-1.d-1 of nonprotein calorie (NPC) and 0.56 g.kg-1.d-1 of nitrogen. 1 g/kg of FDP was also infused to the animals in group TPN + FDP (n = 7) everyday. In the clinical study, the control group received routine TPN, while the study group (n = 16) was treated with TPN plus FDP (5 g, two times a day) for 7 days.

In dogs with TPN support, plasma ATP levels were not changed significantly, while the value in the TPN + FDP group increased significantly from 0.18 mumol/L to 0.46 mumol/L at 24 h and 0.51 mumol/L at 48 h (P < 0.01). Muscular ATP increased markedly in the TPN + FDP group. Muscular creatine phosphate values were not significantly changed in the TPN group, but the values increased in the TPN + FDP group from 4.06 mumol/g.wt at the beginning to 4.93 mumol/g.wt at 24 h and 5.60 mumol/g.wt at 48 h (P < 0.05), with a cytochrome oxidase increase in immunohistochemistry stain. In the clinical study, plasma ATP levels increased and urinary 3-methylhistidine production significantly decreased with an improved value for positive accumulative nitrogen balance in the FDP-infused group.

Our results suggest that total parenteral nutrition support with the supplement of fructose-1,6-diphosphate has a positive role in body energy production and protein metabolism in septic animals and stressed patients.