Influence of Preoperative Intravenous Nutrition upon Hepatic Protein Synthesis and Plasma Proteins and Amino Acids

The influence of 3 and 7 days of preoperative intravenous nutrition (IVN) on the capacity for protein synthesis in liver and on concentrations of plasma proteins and amino acids were investigated in patients with gastrointestinal malignancy. Thirty patients with gastrointestinal neoplasms who had lost more than 5 kg of weight over 3 months were randomized into three groups to receive preoperatively: (a) no IVN, (b) IVN for 3 days (0.18 gN/kg/day as amino acid; 30 kcal/kg/day as glucose), or (c) IVN for 7 days. Free access to a hospital diet was available to all patients including 10 patients who had not lost weight who served as controls. In the three groups of patients who had lost weight, median transferrin and fibronectin were lower than for controls, whereas other proteins and amino acids were comparable. After feeding, samples of liver were obtained peroperatively and the potential rates of protein synthesis were calculated from the in vitro incorporation of (14C)-leucine, into protein. Preoperative ...