ISSN:
1432-1238
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Summary Postoperative parenteral nutrition can only be optimally effective if the characteristics of post-traumatic metabolism are taken into account. Two main possibilities are discussed for the carbohydrate component of parenteral nutrition during this phase: glucose with high doses of insulin or non-glucose carbohydrates (sugar substitutes) possibly in a suitable combination with glucose. The risks as well as the technical and organisational problems involved in the use of them are discussed and the authors prefer the second of the two alternatives. Possible side effects of nonglucose carbohydrates are pointed out and it is shown how these can be avoided by observing dose guidelines. So far a combination of fructose : glucose : xylitol in a ratio of 2 : 1 : 1 with a total dose of 0.50 g/kg/hour has been studied most thoroughly. This combination normalises the fat metabolism and improves glucose tolerance without requiring exogenous insulin. Experiences with this combination as well as individual non-glucose carbohydrates in the postoperative phase are mentioned. Controlled infusions of non glucose carbohydrates on operated patients have been given continuously for up to 7 days and in some cases even for several weeks. No side effects, no deviations from a steady state and no abnormal changes of the laboratory values occurred. The authors are of the opinion that non glucose carbohydrates are necessary if the facilities for frequent blood sugar controls are not available.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF00571657
