LONG-TERM EFFECTS OF POSTOPERATIVE TOTAL PARENTERAL-NUTRITION SUPPLEMENTED WITH GLYCYLGLUTAMINE ON SUBJECTIVE FATIGUE AND MUSCLE PROTEIN-SYNTHESIS

Seventeen patients undergoing elective open cholecystectomy were given conventional total parenteral nutrition either with (nine patients) or without (eight) glutamine supplementation of 20 g/day for 3 days after surgery and thereafter ordinary food for the following 27 days. Muscle protein synthesis, as assessed by the total concentration of ribosomes, decreased in control patients on day 3 following surgery and remained low on days 10, and 30 (P < 0.05). In patients who received glutamine the total ribosome concentration was maintained on the third day after operation. Concurrently, the subjective feeling of fatigue increased on days 3 and 10 after surgery and the nitrogen balance was negative after operation in both groups, without any difference related to glutamine supplementation. Intravenous glutamine after surgery counteracts a decline in muscle protein synthesis only for as long as it is provided.