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THE NUTRITIONAL REQUIREMENTS FOR NITROGEN BALANCE IN SURGICAL PATIENTS DURING THE EARLY POSTOPERATIVE PERIOD 1

1947; American Society for Clinical Investigation; Volume: 26; Issue: 1 Linguagem: Inglês

10.1172/jci101786

1558-8238

Cecilia Riegel, C. Everett Koop, John H. Drew, Laurel Stevens, Jonathan E. Rhoads, Louisa Bullitt, Dorothy Barrus, R. P. Grigger, Marie Barnes, Anne Barnhart, Janet Boger, Frances Bowen, Eina Goulding, Eleanor Mcginley,

Clinical Nutrition and Gastroenterology

The role of protein nutrition in the convales- cence of surgical patients has been emphasized by many authors during the past 15 years, and much of this work has recently been ably reviewed by Lund (1).The observations of Cuthbertson (2), confirmed by Howard and his co-workers (3), that fractures of long bones resulted in a marked negative nitrogen balance which could not be over- come by substantial increases in the protein intake, raised certain questions regarding the possible ef- fects on nitrogen requirements and nitrogen balance of extensive surgical operations.It seemed important to know how soon after operation a positive nitrogen balance could be re-established, and what levels of nitrogen and caloric intake would be required to accomplish this.Many of the previous concepts of the protein nu- trition of surgical patients have been based on changes which were found in the serum protein concentration at different periods.It is generally acknowledged that the use of such data may lead to erroneous conclusions, but they have continued to be used by many investigators chiefly because of the difficulties in carrying out the more inform- ing balance studies.In this project, additional technical aid made it possible for us to carry out both types of study.Our results indicate that the serum protein concentration may, at times, in- crease in spite of a negative nitrogen balance dur- ing the period of study.It has also been possible to compare the effec- tiveness of whole protein with various preparations