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American Journal of Clinical Nutrition, Vol 54, 1087-1092, Copyright © 1991 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Reducing parenteral energy and protein intake improves metabolic homeostasis after bone marrow transplantation

A Taveroff, AH McArdle and WB Rybka
Department of Medicine, Montreal General Hospital, Quebec, Canada.

The purpose of this prospective study was to compare the metabolic effects of reducing parenteral energy and protein intake in bone-marrow- transplant (BMT) patients from 150% (hi-TPN group) to 100% (lo-TPN group) basal energy expenditure. Cytotoxic therapy was given on days 1- 5, BMT on day 6, and TPN beginning on days 6 or 7. The lo-TPN group exhibited higher serum albumin (38 +/- 0.4 vs 32 +/- 0.4 g/L, P less than 0.01) but similar nitrogen balance (-83 +/- 8 vs -86 +/- 8 mg.kg- 1.d-1, P greater than 0.05). Serum Na+ remained greater than 134 +/- 1 mmol/L in the lo-TPN group but fell to 127 +/- 1 mmol/L in the hi-TPN group (P less than 0.001) despite similar Na+ intakes and balances. Serum K+ remained less than 4.4 +/- 0.2 mmol/L in the lo-TPN group but rose to 5.1 +/- 0.1 mmol/L in the hi-TPN group (P less than 0.01) despite similar K+ intakes and balances. Delivering TPN at lower-than- normal rates after BMT appears to minimize Na+ and K+ disturbances and improve serum albumin concentrations without having any adverse effect on nitrogen balance.


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Copyright © 1991 by The American Society for Nutrition