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Comparison of the Effects of Continuous and Cyclic Nocturnal Parenteral Nutrition on Energy Expenditure and Protein Metabolism
Author(s) -
Lerebours Eric,
Rimbert Agnés,
Hecketsweiler Bernadette,
Hellot MarieFrance,
Denis Philippe,
Colin Raymond
Publication year - 1988
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607188012004360
Subject(s) - parenteral nutrition , respiratory quotient , enteral administration , calorie , nitrogen balance , medicine , resting energy expenditure , regimen , zoology , energy expenditure , energy metabolism , chemistry , nitrogen , biology , organic chemistry
Although cyclic nocturnal total parenteral nutrition is a widely used technique, its metabolic consequences have not been fully investigated. During two successive 7‐day periods, 12 patients received randomly either standard continuous (infusion 24 hr/day) or cyclic (infusion between 5 pm and 9 am) total parenteral nutrition (TPN). Calorie and nitrogen intakes were identical during both periods. Energy expenditure was investigated by indirect calorimetry and showed practically no difference between continuous standard (1383 ± 41 kcal/ day −1 ) and cyclic total parenteral nutrition (1428 ± 46 kcal/ day −1 ). However, in the cyclic regimen, when compared with continuous infusion, energy expenditure was higher between 5 pm and 9 am and lower between 9 am and 5 pm. At the end of the noninfusion period, the 24‐hr profile of the nonprotein respiratory quotient showed a slight decrease in patients receiving the cyclic infusion, in contrast with the stability of the quotient in the standard regimen. However, the nitrogen balance and variations in nutritional status did not differ significantly. In conclusion cyclic TPN is efficient for achieving a positive energy and nitrogen balance and in addition it induces a metabolic profile closer to physiological conditions. (Journal of Parenteral and Enteral Nutrition 12 :360–364, 1988)