INFLUENCE OF TOTAL PARENTERAL-NUTRITION ON FUEL UTILIZATION IN INJURY AND SEPSIS
INFLUENCE OF TOTAL PARENTERAL-NUTRITION ON FUEL UTILIZATION IN INJURY AND SEPSIS
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DOI：
10.1097/00000658-198001000-00008
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发表时间：
1980-01-01
影响因子：
9
通讯作者：
KINNEY, JM
中科院分区：
文献类型：
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作者：
ASKANAZI, J;CARPENTIER, YA;KINNEY, JM
对18名营养缺乏的患者给予具有高渗葡萄糖/AA [氨基酸]溶液的全胃肠外营养导致呼吸商（RQ）从0.83上升到1.05（P < 0.001），而O2消耗（≥ VO 2）仅增加3%。如RQ > 1.0所证明的，耗竭患者中过量的葡萄糖转化为脂肪。对14名高代谢患者（损伤/感染）施用类似的葡萄糖负荷导致RQ从0.76上升到0.90，而VO 2增加29%（P < 0.001）。在高代谢患者中，即使给予的葡萄糖量高于能量消耗，仍持续利用脂肪作为能量，导致RQ显著< 1.0。在这些情况下，过量的葡萄糖显然转化为糖原，而脂肪储存则用于部分满足能量需求。脓毒症和受伤的人似乎优先利用内源性脂肪作为能源。向高代谢患者施用大的葡萄糖负荷并不像在消耗患者中那样完全抑制净脂肪氧化;存在VO 2的增加、脂肪的持续氧化和葡萄糖向糖原的转化的明显增加。
Total parenteral nutrition with hypertonic glucose/AA [amine acid] solutions given to 18 nutritionally depleted patients resulted in a rise in the respiratory quotient (RQ) from 0.83 to 1.05 (P < 0.001) while O2 consumption (.ovrhdot.VO2) increased only 3%. Excess glucose in depleted patients was converted to fat as evidenced by a RQ > 1.0. Administration of a similar glucose load to 14 hypermetabolic patients (injury/infection) resulted in a rise in RQ from 0.76 to 0.90, while .ovrhdot.VO2 increased 29% (P < 0.001). In hypermetabolic patients even with administration of glucose in quantities above energy expenditure there was ongoing utilization of fat for energy, resulting in a RQ significantly < 1.0. Excess glucose under these circumstances is apparently converted to glycogen while fat stores are utilized to partially meet energy needs. Septic and injured man seems to preferentially utilize endogenous fat as an energy source. Administration of a large glucose load to hypermetabolic patients does not totally suppress the net fat oxidation as it does in depleted patients; there is an increase in .ovrhdot.VO2, continuing oxidation of fat and apparently an increase in the conversion of glucose to glycogen.