Document Detail


Glucose and protein kinetics in patients undergoing colorectal surgery: perioperative amino acid versus hypocaloric dextrose infusion.
MedLine Citation:
PMID:  20427061     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Surgical injury provokes a stress response that leads to a catabolic state and, when prolonged, interferes with the postoperative recovery process. This study tests the impact of 2 nutrition support regimens on protein and glucose metabolism as part of an integrated approach in the perioperative period incorporating epidural analgesia in 18 nondiabetic patients undergoing colorectal surgery. To test the hypothesis that parenteral amino acid infusion (amino acid group, n = 9) maintains glucose homeostasis while maintaining normoglycemia and reduces proteolysis compared with infusion of dextrose alone (DEX group, n = 9), glucose and protein kinetics were measured before and on the second day after surgery using a stable isotope tracer technique. Postoperatively, the rate of appearance of glucose was higher (P < .001) and blood glucose increased more (P < .001) in the DEX group than in the amino acid group. The postoperative increase in the appearance of leucine from protein breakdown tended to be greater (P = .077) in the DEX group. We conclude that perioperative infusion of a nutrition support regimen delivering amino acids alone maintains blood glucose homeostasis and normoglycemia and tends to have a suppressive effect on protein breakdown compared with infusion of dextrose alone.
Authors:
Andrea Kopp Lugli; Thomas Schricker; Linda Wykes; Ralph Lattermann; Franco Carli
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-04-28
Journal Detail:
Title:  Metabolism: clinical and experimental     Volume:  59     ISSN:  1532-8600     ISO Abbreviation:  Metab. Clin. Exp.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-26     Completed Date:  2010-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375267     Medline TA:  Metabolism     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1649-55     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Anesthesia, McGill University, Montreal, Canada H3A 1A1. akopp@uhbs.ch
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Amino Acids / administration & dosage*
Analgesia, Epidural
Blood Glucose / metabolism
Colon / surgery
Digestive System Surgical Procedures / methods*
Female
Glucose / administration & dosage*
Homeostasis
Humans
Kinetics
Male
Middle Aged
Perioperative Period / methods*
Proteins / metabolism
Rectum / surgery
Grant Support
ID/Acronym/Agency:
MOP 64456//Canadian Institutes of Health Research
Chemical
Reg. No./Substance:
0/Amino Acids; 0/Blood Glucose; 0/Proteins; 50-99-7/Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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