[Postoperative low-calorie parenteral feeding]

In parenteral nutrition a distinction can be made between hypocaloric, normocaloric, and hypercaloric forms, depending on the amount of energy supply. Hypocaloric parenteral nutrition has been specifically adjusted to the conditions of postoperative metabolism. Doses between 1.2 g and 1.5 g/kg body weight/d of amino acids are the most important components of peripheral venous nutrition. The economy of amino acid utilisation, primarily by patients not adapted to fasting or to ketone body utilisation, can be improved by a low dosage of 2.5 g of carbohydrates to 1 g of amino acids. Polyols were found to be decisively superior to glucose as energy carriers by taking into much closer consideration the mechanisms of autoregulation in postoperative metabolism and by favouring synthesis of intrahepatic functional proteins to peripheral synthesis. Hypocaloric peripheral venous parenteral nutrition has proved to be effective therapeutic concept by which to bridge the early postoperative phase in elective surgery.