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Does Portal Nutrition Benefit Liver Protein Synthesis?
Author(s) -
Bozzetti Federico,
Regalia Enrico,
Barbieri Angelo,
Facchetti Giorgio,
Bombardieri Emilio,
Montalto Fabrizio,
Cozzaglio Luca,
Gennari Leandro
Publication year - 1993
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 - 10.1177/014860719301700120
Subject(s) - medicine , parenteral nutrition , nitrogen balance , albumin , gastroenterology , basal (medicine) , randomized controlled trial , acute phase protein , surgery , inflammation , physics , quantum mechanics , insulin , nitrogen
There are only a few experimental investigations on the feasibility and potential advantages of intraportal nutrition in animals and only two uncontrolled studies in humans. The purpose of this study was to compare some metabolic variables in patients who received portal or systemic nutrition after elective surgery for colorectal cancer. Twenty patients were randomized to receive postoperatively for a week a hypocaloric, “protein sparing” standard infusion via the portal (catheter in the gastroepiploic vein) (10 patients) or systemic (10 patients) route. We evaluated the basal concentrations of some visceral and acute‐phase proteins and their variations in the first postoperative week and the nitrogen balance. Statistical analysis was performed by the two‐tailed Student t test. There was no difference in the daily changes of the visceral and acute‐phase proteins after surgery in the two groups of patients, but in the portal group there was a significantly better recovery of the level of total protein, albumin, and cholinesterase at the end of the portal infusion vs the systemic group ( p ≤.005,.03, and.02, respectively). In regard to the nitrogen balance, although there was no difference in the overall balance between portal and systemic nutrition, if we separate the acute phase of the injury from the later one we do not see any significant difference in the first period but we do see a highly significant advantage for the portal group during the last 2 days ( p ≤.0001). These data suggest that short‐term portal nutrition is feasible and safe, with metabolic effects that are at least similar to and possibly better than those of systemic nutrition. (Journal of Parenteral Nutrition 17:20–24, 1993)