[Energy and protein needs of surgical patients]

Energy and protein requirements following operation, are those levels which permit the best possible use of fatty and protein body reserves, without the resistance to trauma becoming diminished. The fatty reserves in a 70 kg man, correspond to 72 000 calories and require, to be used without danger of acidosis, 100 or, preferably, 200 g of glucose daily. Energy expenditure may be about 1 200 calories, thus much less than one would think. Fat does not have the antiketosis effects, nor the nitrogen sparing effects of glucose and their interest in raising calory intake has not been demonstrated. There is a level of nitrogen intake of about 20 to 30 g of protein, below which, nitrogen balance becomes rapidly negative and one then has to increase considerably the protein intake to 80 or 90 g to restore nitrogen balance. 200 g of carbohydrate, then 20 to 30 g of amino-acid, provide a calory intake of 900, easily administrable by the parenteral route, without the danger of bacteremia with more hypertonic solutions in infected operated patients. Higher calory intakes are only indicated in multiple trauma and burns.