Postoperative Oral and Intravenous Nutrition

Oral and intravenous high calorie-amino acid nutritional therapy postoperatively resulted in significant weight gain, improved colonic wound healing and maintenance of normal intravascular albumin levels. Provision of caloric needs without amino acids minimized weight loss postoperatively. However, infusion of hypertonic dextrose solutions resulted in severe generalized hepatic fatty infiltration and marked hypoalbuminemia. Protein and calorie deprivation by administration of 5% dextrose and water resulted in the greatest postoperative weight loss, reduced intravascular albumin levels and decreased colonic anastomotic strength. Comparison of oral and intravenous diet administration demonstrated that hypertonic dextrose infusion was markedly deleterious to hepatic morphology and serum protein metabolism in normal rats. Further clinical investigation appears indicated in previously well-nourished patients undergoing extensive surgery who will not be able to ingest adequate nutrients in the postoperative period.