Nitrogen balance in postoperative patients receiving parenteral nutrition

C. W. Van Way 3rd, H. C. Meng and H. H. Sandstead

Fifteen patients were given parenteral nutrition with hyperosmolar glucose during the postoperative period (days 1 to 5): nine received an average of 10.5 gm of nitrogen and 2,340 kilocalories/day, six were given an average of 5.9 gm of nitrogen and 1,600 kilocalories/day. Eight patients (controls) received no nitrogen and 520 kilocalories/day. The results of this study confirm our early findings that total parenteral nutrition is capable of reversing the negative nitrogen balance of the immediate postoperative period; this reversal depends on administration of adequate nitrogen and calories. In patients with moderate surgical procedures, at least 8 gm of nitrogen and 1,800 kilocalories/day are required to correct the negative nitrogen balance. When total parenteral nutrition is instituted, adequate nitrogen and calories should be given even if insulin is required to control hyperglycemia.