[Maltose--an alternative in hypocaloric parenteral nutrition?]

The carbohydrate balance and nutritive efficacy of a completed nutritional solution with maltose were compared to an isocaloric completed nutritional solution with glucose by means of a hypocaloric parenteral nutrition after colorectal resections.

Prospective, randomised, double blind phase II trial (study group: maltose; control group: glucose). The infusion rate of maltose amounted to 0.05g maltose/kg body-weight/hour and was given postoperatively over 5 days by an infusion pump.

Plasma glucose concentrations were similar low in both groups; indeed in the study group a significant higher renal carbohydrate loss of 7.1% was found compared to the control group with 0.4% (p < 0.001). In the study group three patients showed renal carbohydrate losses over 10% without finding a risk factor for these high renal losses. The cumulative nitrogen balance amounted to -3g N in both groups (p > 0.1). The labile plasma proteins in the 2 groups revealed almost identical concentration courses. No essential surgical complications occurred; no clinical side effect or incompatibility of the maltose solution were observed.

Postoperative hypocaloric nutrition with maltose is possibly nutritive and energetic sufficient under conditions of a clinical study. Indeed, the deviations of the carbohydrate balance show the problems of the low and individual different metabolic capacity of maltose. Thus general use in daily routine seems not favourable due to the necessary precise management (application by infusion pump, daily quantitative examination of renal carbohydrate losses).