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Lipid fuel metabolism after abdominal surgery
S N Georgiannos1, A H James, B C Ang
1Surgical Unit, Royal London Hospital Medical College, Whitechapel, England.
International Surgery
|January 1, 1994
Summary
Surgical stress increases non-esterified fatty acids (NEFA) and ketone bodies without carbohydrate. Glucose infusion mitigates these fuel changes, highlighting the liver's role in post-operative fatty acid metabolism.
Area of Science:
- Metabolic research
- Surgical patient care
- Biochemistry
Background:
- Post-operative metabolic changes are critical in patient recovery.
- Understanding fuel interrelationships aids in optimizing surgical patient management.
- Surgical stress significantly impacts the body's energy metabolism.
Purpose of the Study:
- To investigate the interrelationship between different fuel substrates in surgical patients.
- To determine the effect of saline versus glucose infusion on metabolic markers.
- To elucidate the role of the liver in post-operative fatty acid turnover.
Main Methods:
- Two groups of 13 surgical patients were infused with saline or glucose.
- Blood concentrations of non-esterified fatty acids (NEFA), ketone bodies, lactate, and glucose were measured.
- Measurements were taken on the day of surgery and up to the fifth post-operative day.
Main Results:
- Surgical stress elevated NEFA and ketone bodies in patients not receiving carbohydrates.
- Glucose infusion reduced fatty acid and ketone body concentrations.
- Lactate and glucose levels increased on the day of surgery in both groups, declining thereafter.
- Ketone bodies remained elevated post-operatively despite falling NEFA levels.
Conclusions:
- Impaired glucose utilization post-surgery is not solely due to increased lipid oxidation.
- Glucose administration influences the metabolic response to surgical stress.
- The liver plays a significant role in post-operative fatty acid metabolism.