Fructose-1, 6-diphosphate-added total parenteral nutrition in septic animals and stressed patients

Objective To investigate the roles of fructose-1, 6-diphosphate (FDP)-added total parenteral nutrition (TPN) in septic animals and stressed patients. Methods Thirteen adult dogs were randomly assigned to one of two study grou ps 6 hours after the induction of severe intra-abdominal infection. Group T PN (n = 6) received 70 kcal (.) kg(-1) (.) d(-1) of nonprotein calorie (NPC ) and 0.56 g (.) kg(-1) (.) d(-1) of nitrogen. 1 g/kg of FDP was also infus ed to the animals in group TPN + FDP (n = 7) everyday. In the clinical stud y, the control group received routine TPN, while the study group (n = 16) w as treated with TPN plus FDP (5 g, two times a day) for 7 days. Results In dogs with TPN support, plasma ATP levels were not changed signif icantly, while the value in the TPN + FDP group increased significantly fro m 0.18 mu mol/L to 0.46 mu mol/L at 24 h and 0.51 mu mol/L at 48 h (P < 0.0 1). Muscular ATP increased markedly in the TPN + FDP group. Muscular creati ne phosphate values were not significantly changed in the TPN group, but th e values increased in the TPN + FDP group from 4.06 mu mol/g (.) wt at the beginning to 4.93 mu mol/g (.) wt at 24 h and 5.60 mu mol/g (.) wt at 48 h (P < 0.05), with a cytochrome oxidase increase in immunohistochemistry stai n. In the clinical study, plasma ATP levels increased and urinary 3-methylh istidine production significantly decreased with an improved value for posi tive accumulative nitrogen balance in the FDP-infused group. Conclusion Our results suggest that total parenteral nutrition support with the supplement of fructose-1 6-diphosphate has a positive role in body ene rgy production and protein metabolism in septic animals and stressed patien ts.