[Changes in several important metabolic parameters and insulin level during a 7-day total parenteral nutrition under pre- and postoperative conditions]

Abstract

After the 24 hours preoperative infusion period 0.37% glucose, 0.05% fructose and 1.28% xylitol of the infused amount were excreted in the urine. Postoperatively fructose was the best metabolized energy donator before xylitol and glucose. As a sign of an undisturbed hepatic synthesis of lipoproteins the triglycerides rose up to the 5th postoperative day. During the parenteral nutrition and the additional surgical intervention the cholesterol fell from 192.3 to 128.5 mg/100 ml on the first postoperative day. The infusion solutions caused a rise of the insulin concentration from 23.2 to 46.3 U/l on the operation day. There is a positive nitrogen balance of 3.5 g/24 h on the operation day. The slight negative balance of - 1.15 g/24 h on the first postoperative day is reduced to - 0.61 g/24 h on the postoperative day. The changes of the enzymes LDH, GOT and AP were at normal range. The postoperative changes were due to the surgical intervention. Without a simultaneous change of enzymes, 5 patients had a rise of bilirubin up to 1.1 mg/100 ml. To avoid a too great loose of phosphate during a long-term parenteral nutrition period, it is important to put up a balance.