The effects of intravenous protein—calorie supplementation on the tissue composition of postoperative body weight loss

Abstract

Summary The components of postoperative body weight loss were analysed in eleven adult male patients who had uncomplicated abdominal surgery of moderate severity namely vagotomy and a drainage procedure for chronic duodenal ulceration. Four patients (Group I) had the routine postoperative regimen which consisted of intravenous isotonic dextrose and dextrose-saline solutions. Another group of four patients (Group IIa) had supplementation of this regimen with 50% dextrose and an amino-acid/sorbitol preparation whilst a group of three (Group IIb) patients had supplementation with only amino-acid/sorbitol preparation. Group I patients exhibited the expected losses of lean tissue and body fat, but these were partially obscured by retention of extracellular water. Group IIa exhibited excessive loss of extracellular water which was parallel to an increased urine flow and this loss completely overshadowed the reduction in lean tissue and body fat losses produced by the protein and calorie supplementation. Group IIb patients exhibited the smallest amount of weight loss because they had a reduction in lean tissue and body fat losses whilst they still exhibited a mild antidiuretic response. It is suggested that the amino-acid/sorbitol preparation provides the safest form of supplementation, particularly in the face of increased extra-renal losses of water such as may be dictated by a warm tropical environment.