CLINICAL STUDY ON POSTOPERATIVE INTRAVENOUS INFUSION OF FAT EMULSION

Abstract

Intravenous infusion of fat emulsion during the first postoperative week has not been actively performed, because it may participate in hepatic disturbamce, fat accumulation, and inhibition of reticuloendothelial system. In this study, we have evaluated the significance of postoperative intravenous infusion of fat emulsion by measuring energy metabolism using indirect calorimetry and various nutritional parameters. Twenty patients who underwent subtotal gastrectomy for gastric cancer were divided into two groups: control group (11 patients) recieved 5% dextrose only and fat group (9 patients) recieved fat emulsion during 5 consecutive postoperative days in addition to 5% dextrose. Total calory administered was equivalent in these two groups. As a result, an increase in resting energy expenditure and a decrease in respiratory quotient are achieved as well as an increase in fat oxidation in fat group. Of the nutritional parameters, retinol binding protein concentration increased significantly from early days following surgery. It is revealed from this study that endogenous fat is mainly utilized during catabolic phase at the early post operative days, however, intravenously administered exogenous fat can be definitely utilized as an energy substrate.