Parenteral feeding of surgical patients]

1. Under stress an increased amount of labelled amino acids is incorporated. 2. Under the conditions of stress amino acids too participate in the process of synthesis. 15N-glycine was used as tracer in a quantity of 0.64 g of amino acid and 24 kcal per kg per day, that is at a 0.027 g per kcal. hour infusion rate, so that the infused 15N corresponded to 75% of the total residual nitrogen in healthy subjects and 57% in operated patients. 3. Sixteen percent of the infused 15N is secreted with the urine of healthy subjects as urine nitrogen, and 57% as urine nitrogen and 4--5% as ammonia nitrogen with the urine of the operated cases. 4. In contrast to normal conditions, under stress a higher percentage of the infused amino acids participates in energy production. 5. Stress enhances uropoiesis as in regards both quantity and speed. 6. No difference in acid-base balance was found in the case of postoperative infusion; urinary and plasma concentrations remained within normal limits.     

Parenteral or enteral feeding in intensive therapy?

Attention is first called to the reasons underlying resort to hyperalimentation. Difficulties and complications for both parenteral and enteral techniques are then indicated. Stress is laid on the importance of reassessing the enteral route and the commonest formulas are indicated on the basis of the literature and personal experience. Finally, a procedure for artificial enteral feeding providing for the use of the precooked foods used in infancy is described.