Postoperative positive nitrogen balance with intravenous hyponutrition and growth hormone

Abstract

11 patients having major gastrointestinal surgery were allocated at random to receive either biosynthetic human growth hormone (BSHGH) 0.1 mg/kg or placebo daily for the first 7 postoperative days. All patients received the same intravenous feeding regimen, which contained 2.09 MJ glucose, 1.88 MJ fat, and 7 g N daily. Patients receiving BSHGH were in positive nitrogen balance throughout the study (mean 1.8 [SEM 0.4] g N/day) and those receiving placebo were in negative nitrogen balance (mean -0.9 [0.7] g N/day). Resting energy expenditure progressively increased in the patients receiving BSHGH (115.7% [14.8] on day 7) but remained unchanged in patients receiving placebo (99.35% [1.4]). Fat oxidation was nearly three times higher in the patients on BSHGH (4.09 [0.38] MJ/day) than in controls (1.38 [0.50]). Carbohydrate oxidation remained about the same in both groups. Whole-body protein turnover, synthesis, and breakdown were increased in the patients receiving growth hormone.