[Importance of lipid metabolism in the overcoming of trauma].

We studied the pre- and postoperative lipid metabolism in 24 metabolically healthy surgical patients who had to undergo gastric resection during intravenous substitional infusion. Group I, n = 10, received 0,36 g/kg Bw x h of a carbohydrate mixture solution together with 1.14 g L-crystalline amino acids/kg Bw . day. Group II, n = 11, received 0.11 g Glucose/kg Bw x h; group group III, n = 13, received 0.11 g Xylitol/kg Bw x h. Both groups II and III received 1.71 g L-crystalline amino acids/kg Bw x day. After the preoperative infusion period the free fatty acids fall significantly in all groups. beta-hydroxybutyrate falls on the operation-day in all groups also with no significance. Postoperatively the free fatty acid levels remain significantly reduced in all groups. From postoperative day 1 to 5 the FFA levels in group III are significantly higher compared with group I and II. From postoperative day 2 on beta-hydroxybutyrate levels rise in all groups. From postoperative day 1 on beta-hydroxybutyrate and acetacetate levels in group III are significantly higher compared with group I and II. In conclusion the hypocaloric postoperative infusion of xylitol directs fat metabolism to reasonable physiologic pathways. A short term postoperative hypercaloric nutrition seems inadequate in patients with normal body weight.