Alteration of Protein and Energy Metabolism and Effect of Nutritional Management in Surgical Stress

Tsuguhiko Tashiro, Hideo Yamamori, Masahiko Nishizawa, Yoshiya Mashima, Nobuyuki Nakajima

First Department of Surgery, Chiba University School of Medicine

The effects of surgical stress and the nutritional management on the kinetics of protein and energy substrates were studied. The measurements of glycerol turnover rate, indirect calorimetry, plasma FFA and ketone body on 46 postoperative patients receiving gastric, colorectal and esophageal operations, and those of whole body protein turnover on 61 patients revealed the increased energy expenditure and the rates of fat and protein turnover in surgical stress. The increases were in proportionate with the stress level indicated by the excretion of urinary total catecholamines. The increase of protein dose from 1.0 to 1.5 or 2.0 g/kg/d in 52 patients, the administration of 30% BCAA solution in 38 patients and the supplementation of human growth hormone (24 IU/g) in 12 esophagectmized patients improved postoperative protein metabolism. The increased whole body protein synthesis, not the supression of breakdown, contributed to the improvement of protein metabolism.

Key words
whole body lipolytic rate, whole body protein turnover rate, indirect calorimetry

Reprint requests
Tsuguhiko Tashiro First Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Chuo-ku, Chiba-shi, 260 JAPAN

Accepted
July 6, 1992

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