INTRAVENOUS GLUCOSE, AMINOACIDS, AND FAT IN THE POSTOPERATIVE PERIOD A Controlled Evaluation of Each Substrate

Craig, R P; Tweedle, D. E. F.; Davidson, H; Johnston, Ian

doi:10.1016/s0140-6736(77)90004-6

Cited by 35 publications

(13 citation statements)

References 14 publications

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“…The demonstration of a proteinsparing effect of amino acid sohtions alone, at a time when muscle protein breakdown is of little consequence, should not suggest their routine postoperative use. This study supports the conclusion of Craig et al (1977) and Freeman et al (1977) that there is no indication for the used of amino acid solutions in postoperative patients who make an uneventful recovery and soon resume oral feeding.…”

Section: 6supporting

confidence: 90%

Postoperative amino acid infusions: An appraisal

Clark

1978

Journal of British Surgery

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Amino acid infusions either as a 7 per cent solution or as an isotonic 3.5 per cent solution produce a nitrogen-sparing effect in the postoperative period. The nitrogen-sparing effect is independent of the concentration and rate of infusion of the amino acid solution; or of any changes in plasma substrate and hormone concentrations. These solutions have no advantage over conventional intravenous therapy with isotonic glucose and saline solutions and there is no indication for their routine use in the management of postoperative patients.

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Section: 6supporting

confidence: 90%

Postoperative amino acid infusions: An appraisal

Clark

1978

Journal of British Surgery

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“…The same amount of glucose reduces the nitrogen loss during starvation, but there are conflicting conclusions about its effect on nitrogen loss after surgery (Benotti et al, 1977;Craig et al, 1977). This paper describes the effects of 129 g/day of glucose and 30 g/day of glucose on the metabolite concentrations and urine nitrogen in patients after moderate uncomplicated surgery in order to clarify the conflicting results reported in the literature.…”

Section: Introductionmentioning

confidence: 94%

“…After surgery, as during starvation, there is an increase in the concentration of ketone bodies in the blood (Benotti et al, 1977;Craig et al, 1977), and a loss of nitrogen from the body (Cuthbertson, 1936;Moore, 1953).…”

Section: Introductionmentioning

confidence: 99%

“…Glucose (150 g/day) prevents the increase in ketone bodies in the 3 to 4 days after surgery (Benotti et al, 1977;Craig et al, 1977) and abolishes the ketosis during starvation (Aoki et al, 1975). The same amount of glucose reduces the nitrogen loss during starvation, but there are conflicting conclusions about its effect on nitrogen loss after surgery (Benotti et al, 1977;Craig et al, 1977).…”

Section: Introductionmentioning

confidence: 99%

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The effect of varying amounts of intravenous glucose on the metabolic changes after surgery

Swaminathan

Bradley

Hill

et al. 1980

Postgraduate Medical Journal

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The metabolic effects of saline, 30 of glucose a day and 129 g of glucose a day were studied in patients after either cholecystectomy or highly selective vagotomy. In the saline group the blood ketone concentration increased to 3.3 mmol/l on the 5th day after surgery, but this increase was completely abolished by a daily intake of 129 g of glucose and almost completely so by 30 g of glucose. Urine nitrogen excretion expressed as nitrogen to creatinine ratio in the saline group increased from 42.5 to 66.2 by the third day after surgery, and there was a similar increase in the group given 30 g a day of glucose. However, 129 g/day of glucose completely prevented the increase in urine nitrogen, an effect which is similar to that reported in starving subjects given similar amounts of glucose. It is suggested that 129 g of glucose only prevents that part of the increase in nitrogen excretion which is due to starvation and that it has no effect on the increase in nitrogen excretion which happens as part of the metabolic response to surgery.

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“…In the comparison of groups of patients the problem can be avoided by carefully matching the groups in age, sex, weight and even fat-free mass (Craig et al, 1977). The application of these observations to the assessment and management of the individual patient depends on what is required.…”

Section: Discussionmentioning

confidence: 99%

The nitrogen to creatinine ratio in untimed samples of urine as an index of protein catabolism after surgery

Swaminathan¹,

Hill²,

Bradley³

et al. 1979

Postgraduate Medical Journal

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SummaryThe loss of nitrogen after surgery is said to be related to body size as well as to the magnitude of the metabolic effects of surgery. Urine nitrogen should be 'corrected' for body size before it can be taken as a guide to the severity of surgery in the individual. Twenty-three patients were studied after elective abdominal surgery of moderate severity, when they were having only 3 litres of dextrose saline daily. The 24-hr urine nitrogen excretion (mean of days 3 and 4) was correlated with 3 indices of body size, body weight (r=0-614), fat-free mass (r=0O743) and 24-hr creatinine excretion (r=0-780).Nitrogen excretion was corrected for body size by calculating the ratio of nitrogen to each index. For each index the s.d. of this corrected nitrogen excretion at the mean value of the index was less than the s.d. of the uncorrected data. The nitrogen: creatinine ratio in an untimed urine sample was closely related to the ration in the 24-hr urine (r=0914). These results demonstrate that nitrogen excretion after surgery is related to body size and can be corrected for body size by calculating the nitrogen: creatinine ratio in an untimed urine.

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INTRAVENOUS GLUCOSE, AMINOACIDS, AND FAT IN THE POSTOPERATIVE PERIOD A Controlled Evaluation of Each Substrate

Cited by 35 publications

References 14 publications

Postoperative amino acid infusions: An appraisal

Postoperative amino acid infusions: An appraisal

The effect of varying amounts of intravenous glucose on the metabolic changes after surgery

The nitrogen to creatinine ratio in untimed samples of urine as an index of protein catabolism after surgery

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