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Effects of postoperative carbohydrate overfeeding
N M Vo1, M Waycaster, R V Acuff
1Mountain Home Veterans Administration Center, Johnson City, Tennessee.
The American Surgeon
|November 1, 1987
Summary
Excessive carbohydrate intake during postoperative nutrition may increase patient morbidity and mortality. This study suggests that a high respiratory quotient (RQ) indicates potential overfeeding, leading to higher complication rates.
Area of Science:
- Metabolism
- Nutritional Support
- Critical Care Medicine
Background:
- Postoperative nutritional support is crucial for patient recovery.
- Assessing metabolic status via respiratory quotient (RQ) can indicate substrate utilization.
- Understanding the impact of nutritional composition on outcomes is vital.
Purpose of the Study:
- To investigate the association between respiratory quotient (RQ) and patient outcomes following supplemental postoperative nutrition.
- To determine if carbohydrate overfeeding, indicated by a high RQ, correlates with increased morbidity and mortality.
Main Methods:
- Retrospective analysis of 43 indirect calorimetric studies in 24 patients receiving postoperative supplemental nutrition.
- Patients were grouped based on respiratory quotient (RQ): Group 1 (RQ > 0.95) and Group 2 (RQ < 0.95).
- Comparison of preoperative and postoperative biochemical values, nutritional indices, and clinical outcomes between groups.
Main Results:
- Groups showed similar baseline nutritional and metabolic parameters.
- Group 1 (high RQ) exhibited a trend towards longer postoperative length of stay (P = NS).
- Group 1 demonstrated significantly higher rates of septic episodes (100% vs 40%) and mortality (28% vs 10%) compared to Group 2.
Conclusions:
- Carbohydrate overfeeding, suggested by a high respiratory quotient (RQ > 0.95), may be linked to increased postoperative morbidity and mortality.
- Careful titration of nutritional support is essential to avoid detrimental metabolic consequences.
- Further research is warranted to optimize macronutrient delivery in critically ill patients.