Chronobiological approach to total parenteral nutrition.

点击翻译按钮获取中文摘要

To clarify the effects of nutrient administration pattern on circadian rhythms, body temperature, urine volume and blood hormone levels were measured at 4-hour intervals for 24 hours in patients receiving total enteral nutrition (TEN) with a liquid diet. The patients were divided into two groups, and the diet was continuously given through a day in continuous TEN group, whereas from 8 a.m. to 8 p.m. in cyclic TEN group.In cyclic TEN group, all circadian rhythms examined were nearly normal: that is, body temperature was low in the morning and high in the evening, urinary excretion was less in the morning, and plasma cortisol level was highest in the early morning and lowest in the evening. In contrast, in continuous TEN nutrition, there was no significant circadian rhythmic change in all parameters except urinary excretion. The urine volume showed a normal rhythm regardless of the pattern of nutrient infusion.It was concluded that the pattern of nutrient intake is important for generation and maintenance of normal circadian rhythms and that cyclic TEN is more adequate, at least from a chronobiological standpoint, than continuous TEN, especially when patients were kept under TEN for a long period.