THERMOGENIC RESPONSE TO TOTAL PARENTERAL-NUTRITION IN DEPLETED PATIENTS WITH MULTIPLE ORGAN FAILURE

Nutrient-induced thermogenesis was studied in eight patients with seve re nutritional depletion and multiple organ failure after abdominal su rgery. Energy expenditure (EE) and RQ were recorded continuously over a period of 4 days. On each study day balanced total parenteral nutrit ion was administered during a period of approximately 16 h, followed b y a period of low-energy glucose infusion. The total energy supply was in the order of 110% of the measured EE and the supply of glucose, fa t and amino-acids was 2.6 +/- 0.4, 2.6 +/- 0.2 and 0.84 +/- 0.2 kJ x k g BW-1 x h-1 (mean +/- SD), respectively. The nutrient-induced thermog enesis, expressed as the rise in EE in percent of the energy content o f the administered nutrients, was approximately 5%, which appears to b e lower than previously observed in healthy individuals. A plateau in energy expenditure was reached after 6-8 h in response to parenteral n utrition. It is hypothesized that this plateau reflects the oxidative capacity and thus may be used as a guideline for nutritional therapy.