Study of hypocaloric peripheral parenteral nutrition in postoperative patients (European project)

The objective of this study is to ascertain whether or not the supply of a low-calorie amino acids (AA) parenteral solution is useful in postoperative patients, by assessing a series of parameters that indicate nutritional status. 75 postoperative patients who met at least 2 of the 3 criteria: 1) albumin less than 3 g/dl; 2)prealbumin less than 21 mg/dl; 3) body weight less than 95% of ideal weight, were studied. Patients were divided into 4 groups: control group, 15 patients receiving conventional infusion therapy; group I, 20 patients receiving glucose + AA; group II, 20 patients receiving glycerol + AA; and group III, 20 patients receiving sorbitol-xylitol + AA. The most significant findings were a prompt recovery of short half-life proteins (prealbumin and retinol binding protein), a less negative nitrogen balance, a greater decrease in urinary 3-methylhistidine and a marked increase in most AAs when hypocaloric peripheral parenteral nutrition (HPPN) was used. As regards complications, suture dehiscence occurred in a greater percentage of control patients than in the active therapy groups (13.3% versus 5%) and, in contrast, a greater number of cases of infusion phlebitis was observed in the HPPN groups. Clinical data were not statistically significant. We conclude that HPPN is a valid means for providing nutritional support but, at present, there are few randomized, controlled studies that show that its use is clearly beneficial.