LIPID FUEL METABOLISM AFTER ABDOMINAL-SURGERY

The work investigated fuel interrelationships in surgical patients inf used with saline (Group I) or glucose (Group II) (13 patients in each group) on the day of surgery and subsequently maintained solely on sal ine until the fifth postoperative day. Blood concentrations of non-est erified fatty acids (NEFA) and ketone bodies were markedly increased i n response to surgical stress on the day of surgery only in patients w ho were not administered carbohydrate. Increased concentrations of lac tate and glucose were observed on the day of surgery in patients infus ed with either saline or glucose. As both fatty acid and ketone body c oncentrations were decreased by glucose infusion, impaired glucose uti lization immediately after surgery is not a simple consequence of incr eased oxidation of lipid fuels. Glucose and lactate concentrations dec lined after the day of surgery. Despite a progressive fall in plasma n on-esterified fatty acid concentrations from the first to fifth post-o perative days, blood ketone body concentrations were strikingly elevat ed in both groups of patients. The findings emphasize the role of the liver in post-operative fatty acid turnover.