Effect of Matching Calories Infused to Energy Needs on Metabolic Response -A Prospective Study in Postoperative Patients-

Tetsuhisa Yamamoto, Hidetaka Mochizuki, Katsuyuki Utsunomiya, Naoki Tamane, Manabu Kinoshita, Sakae Okamura, Kazuyoshi Yoshimura, Shoetsu Tamakuma

First Department of Surgery, National Defense Medical College

Twenty-two patients who had undergone gastric or colorectal resection were classified according to their caloric supplementation. The patients were divided into three groups: group I, caloric replacement was matched to energy needs determined by indirect calorimetry; group II, replacement was greater than energy needs; and group III, replacement was less than energy needs. During one week of replacement, alterations in energy needs and respiratory quotient in group I patients were the smallest and were similar to the preoperative values. Urinary cathecolamine excretion was least in group I patients. After one week plasma prealbumin and transferrin levels were the highest in group I patients. These results suggest that avoiding hypo- and hyperalimentation by matching calories to the individual patient's needs is to be preferred in the early postoperative period and that excessive caloric infusion might be a metabolic stress rather than a nutritional support.

Key words
energy expenditure, Indirect calorimetry, postoperative, caloric supplementation

Reprint requests
Tetsuhisa Yamamoto First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
October 9, 1991

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