[Parenteral feeding following heart surgery operations].

After aorto-coronary bypass operations 40 patients were treated in a prospective-randomized study with 3 types of hypocaloric parenteral nutrition consisting of the same content of amino acids (75 g/day) but different amounts of carbohydrates: 120 g dextrose, 120 g or 200 g dextrose/fructose/xylitol (1:2:1) per day. 18 patients received only 75 g/day of dextrose (controls). The fluid volume for parenteral nutrition did not exceed 1500 ml/day. Changes in carbohydrate and protein metabolism were investigated. Because of restricted carbohydrate dosage, we needed no insulin to keep blood glucose within values of about 7-10 mmol/l. Postoperative serum insulin levels were significantly raised to 4-5 fold of preoperative values in all groups. Serum potassium concentrations remained normal under a supply of 80-100 mmol/day. Cumulative nitrogen balances were improved by about 48-58% in groups receiving parenteral nutrition despite a calorie/nitrogen ratio of 40:1 or 66:1 respectively. The expected beneficial effects on the concentrations of visceral serum proteins (transferrin, prealbumin, retinolbinding protein, cholinesterases) could not be found.