PROTEIN-SPARING THERAPY IN POSTOPERATIVE-PATIENTS - EFFECTS OF ADDED HYPOCALORIC GLUCOSE OR LIPID

In patients receiving hypocaloric total parenteral nutrition, protein sparing with infusions of amino acids alone is alleged to occur because low insulin levels allow mobilization of endogenous fat. Four groups of patients studied for their first 4 postoperative days received all their nutrition parenterally as: 150 g/day of glucose, protein (as amino acids, 1 g/kg per day) alone, protein plus 50 g/day of soybean-oil emulsion or protein plus 150 g/day of glucose. All groups of patients receiving protein had lesser negative N balance than patients receiving glucose alone. The addition of glucose to protein did not increase negative N balance. The protein-sparing effect of amino acids appears to be a function of the infused amino acids alone and is not related to the degree of endogenous fat mobilization.