Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1977 Apr;185(4):417–422. doi: 10.1097/00000658-197704000-00008

Effect of carbohydrate and fat intake on nitrogen excretion during total intravenous feeding.

J M Long 3rd, D W Wilmore, A D Mason Jr, B A Pruitt Jr
PMCID: PMC1396128  PMID: 402892

Abstract

Recent availability of intravenous soy bean oil emulsion for clinical trials in the United States prompted infusion of intravenous diets containing a constant nitrogen level (11.7 grams/m2/day) and 13 different combinations of carbohydrate (110-2300 kcal/m2/day) and fat (0-1100 kcal/m2/day) during 34 three-day studies in 5 patients who were clinically stable after injury or operation. Urea nitrogen excretion was inversely related to carbohydrate intake (P less than 0.01) and directly related to resting metabolic rate (P less than 0.01). Fat infusion did not affect nitrogen excretion at any level of carbohydrate intake. This study suggests that, when a primary clinical goal is nitrogen conservation, carbohydrate calories should be given in amounts approximating the resting metabolic rate. Additional calories and essential fatty acids now can be safely given as intravenous fat emulsion, but fat did not affect nitrogen conservation under the conditions of this study.

Full text

PDF
417

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beisbarth H., Krämer K., Schultis K. The role of fat as a calorie course in parenteral nutrition. Z Ernahrungswiss. 1973 Jun;12(2):121–130. doi: 10.1007/BF02023910. [DOI] [PubMed] [Google Scholar]
  2. Borresen H. C., Coran A. G., Knutrud O. Metabolic results of parenteral feeding in neonatal surgery: a balanced parenteral feeding program based on a synthetic 1-amino acid solution and a commercial fat emulsion. Ann Surg. 1970 Aug;172(2):291–301. doi: 10.1097/00000658-197008000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brennan M. F., Moore F. D. An intravenous fat emulsion as a nitrogen sparer: comparison with lucose. J Surg Res. 1973 Jun;14(6):501–504. doi: 10.1016/0022-4804(73)90119-4. [DOI] [PubMed] [Google Scholar]
  4. Caldwell M. D., Jonsson H. T., Othersen H. B., Jr Essential fatty acid deficiency in an infant receiving prolonged parenteral alimentation. J Pediatr. 1972 Nov;81(5):894–898. doi: 10.1016/s0022-3476(72)80539-0. [DOI] [PubMed] [Google Scholar]
  5. Coran A. G., Cryer P. E., Horwitz D. L. Effect of intravenously administered fat on serum insulin levels. Am J Clin Nutr. 1972 Feb;25(2):131–134. doi: 10.1093/ajcn/25.2.131. [DOI] [PubMed] [Google Scholar]
  6. Dudrick S. J., Wilmore D. W., Vars H. M., Rhoads J. E. Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery. 1968 Jul;64(1):134–142. [PubMed] [Google Scholar]
  7. Hallberg D., Schuberth O., Wretlind A. Experimental and clinical studies with fat emulsion for intravenous nutrition. Nutr Dieta Eur Rev Nutr Diet. 1966;8(3):245–281. doi: 10.1159/000175146. [DOI] [PubMed] [Google Scholar]
  8. Helmkamp G. M., Jr, Wilmore D. W., Johnson A. A., Pruitt B. A., Jr Essential fatty acid deficiency in red cells after thermal injury: correction with intravenous fat therapy. Am J Clin Nutr. 1973 Dec;26(12):1331–1338. doi: 10.1093/ajcn/26.12.1331. [DOI] [PubMed] [Google Scholar]
  9. MUNRO H. N. Carbohydrate and fat as factors in protein utilization and metabolism. Physiol Rev. 1951 Oct;31(4):449–488. doi: 10.1152/physrev.1951.31.4.449. [DOI] [PubMed] [Google Scholar]
  10. THOMSON W. S., MUNRO H. N. The relationship of carbohydrate metabolism to protein metabolism. IV. The effect of substituting fat for dietary carbohydrate. J Nutr. 1955 May 10;56(1):139–150. doi: 10.1093/jn/56.1.139. [DOI] [PubMed] [Google Scholar]
  11. VAN ITALLIE T. B., MOORE F. D., GEYER R. P., STARE F. J. Will fat emulsions given intravenously promote protein synthesis? Metabolic studies on normal subjects and surgical patients. Surgery. 1954 Oct;36(4):720–731. [PubMed] [Google Scholar]
  12. Wilmore D. W., Long J. M., Mason A. D., Jr, Skreen R. W., Pruitt B. A., Jr Catecholamines: mediator of the hypermetabolic response to thermal injury. Ann Surg. 1974 Oct;180(4):653–669. doi: 10.1097/00000658-197410000-00031. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Wilmore D. W., Moylan J. A., Helmkamp G. M., Pruitt B. A., Jr Clinical evaluation of a 10 percent intravenous fat emulsion for parenteral nutrition in thermally injured patients. Ann Surg. 1973 Oct;178(4):503–513. doi: 10.1097/00000658-197310000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES