The Outcome of Nutrition Support of Surgery Patients with Hypermetabolic Severity by Total Parenteral Nutrition and Enteral Nutrition and Biochemical Data.
- Author:
Miyong RHA
1
;
Eunmi KIM
;
Young Y CHO
;
Jeong Meen SEO
;
Haymie CHOI
Author Information
1. Department of Dietetics, Samsung Medical Center, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
malnutrition;
nutrition support;
total perenteral nutrition (TPN);
enteral nutrition (EN);
hypermetabolism;
hypermetabolic score
- MeSH:
Bilirubin;
Blood Glucose;
C-Reactive Protein;
Cholesterol;
Enteral Nutrition*;
Fasting;
Fever;
Heart Rate;
Humans;
Inflammatory Bowel Diseases;
Leukocytes;
Leukocytosis;
Leukopenia;
Malnutrition;
Parenteral Nutrition, Total*;
Prospective Studies;
Respiration;
Retrospective Studies;
Serum Albumin;
Weight Loss
- From:Korean Journal of Community Nutrition
2006;11(2):289-297
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
This study evaluated the nutrition intake and changes in laboratory data of surgery patients with hypermetabolic severity on nutrition support. From January 2002 to September 2002, 66 hospitalized surgery patients who had received enteral nutrition (EN, n=19) and total parenteral nutrition (TPN, n=47) for more than 7 days were prospectively and retrospectively recruited. The laboratory data was examined pre-operatively, and on the post-operative 1, 3, 7 day and at the time of discharge. The characteristics of the patients were examined for the hypermetabolic severity, The hypermetabolic scores were determined by high fever (> 38 degrees C), rapid breathing (> 30 breaths/min), rapid pulse rate (> 100 beats/min), leukocytosis (WBC>12,000/microliter), leukocytopenia (WBC<3,000/microliter), status of infection, inflammatory bowel disease, surgery and trauma. The scores for the hypermetabolic status were divided into three groups (mild 0-10, moderate 11-40, severe>41). According to the results of the study, 38.3% (n=23), 45.4% (n=30) and 19.6% (n=13) were in the mild, moderate, and severe groups, respectively. There was a decrease in the serum albumin level and weight loss according to the hypermetabolic severity. However, the white blood cells (WBC), fasting blood sugar (FBS), c-reactive protein (CRP), total bilirubin, GOT, and GPT increased. The nutritional intake was TPN (32.5 kcal/kg, protein 1.2 g/kg, fat 0.25 g/kg), EN (28.1 kcal/kg, protein 1.0 g/kg, fat 1.01 g/kg). The serum albumin, hemoglobin and cholesterol were higher in the EN group than in the TPN group. But the FBS, total bilirubin, GOT and GPT were higher in the TPN group than the EN group. In conclusion, there was a negative correlation between the changes in the laboratory data and the hypermetabolic severity. There was an increase in the number of metabolic complications in the TPN group.
