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[Postoperative infusion therapy: electrolyte solution in comparison with hypocaloric glucose and carbohydrate
K W Jauch1, G Kröner, A Hermann
1Chirurgische Klinik und Poliklinik, Ludwig-Maximilians-Universität München.
Objectives:
Comparison of early postoperative hypocaloric nutrition with glucose or xylitol/sorbitol- amino acid solutions versus saline alone. Influence on substrate, especially protein metabolism.
Design:
Prospective randomized study.
Setting:
Intensive care unit of an university hospital.
Patients:
44 patients in three groups after major surgery with necessity of intensive care.
Results:
Hypocaloric infusions were well tolerated immediately after operation and positively influenced functional proteins and N-balance. During saline infusion protein parameters deteriorated significantly already after 24 to 36 hours. Glucose was not inferior to the xylitol/sorbitol solution and both resulted in a stable metabolic state during four days.
Conclusions:
After major trauma or surgery hypocaloric nutrition should be started within 24 hours and can be given already directly after the operation period without metabolic deterioration.