0100488799

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AN EXPERIMENTAL STUDY ON PARENTERAL NUTRITION IN SEPSIS : EFFECT OF COMBINED HYPERTONIC CARBOHYDRATES OR AMINO ACIDS INFUSION ON POSTINJURY METABOLISMS

English (英語)

The Kobe journal of the medical sciences

29(6)

171-196

1983-12

The present study was undertaken experimentally to reveal the appropriate formula of total parenteral nutrition (TPN) under septic conditions. Rabbits with perforated diffuse peritonitis and consequent sepsis were nourished with four types of nutrients, namely, low calory infusion, conventional TPN (C-TPN), TPN with glucose, fructose and xylitol solution (GFX-TPN) and TPN with high concentrations of amino acids (AA-TPN). In looking at the general conditions and immune defense mechanism, each parameter seemed to confirm that TPN played an important role in improving malabsorptive status and depressed immune defense mechanism in sepsis. However, no definite pieces of evidence were obtained in these studies to show the best TPN composition to combat sepsis. Routine nutritional assessment revealed that GFX-TPN and AA-TPN were of metabolic advantage. In addition to the results of blood glucose and insulin levels, F2,6P2 content and F6P2K activity in the liver suggested that glycolysis would be maintained better in GFX-TPN than in both C-TPN and AA-TPN in situations of severe stress such as sepsis. Changes of serum TG, FFA and keton body and of liver TG content suggested that lipogenesis was enhanced by TPN while lipid utilization was depressed due to high blood glucose and insulin in C-TPN and not depressed due to the relatively low blood glucose and insulin in GFX-TPN and AA-TPN. In view of glucose and lipid metabolism, therefore, GFX-TPN and AA-TPN were superior to C-TPN, whereas no differences between former two could be found.

immune defense mechanism

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