Controlled study of early postoperative parenteral nutrition in children

Background/Purpose: Nutritional support of surgical patients has improved in recent years because of the possibility of modulating catabolism and anabolism, thus enhancing the immune response and repair processes. The objective of this study was to evaluate metabolic effects of early parenteral nutrition (PN) after major surgery. Methods: The authors studied 63 children aged 4 to 14 yea rs with diffuse peritonitis caused by perforated-suppurative appendicitis. They were assigned randomly to a study group (SG, n = 31), which received PN for 5 days, starting 24 to 48 hours after surgery or to a control group (CG, n = 32), that received standard treatment (fluids). Weight, C-reactive protein [CRP), albumin, prealbumin, glycemia, nitrogen balance (NB), and insulinlike growth factor (IGF-I), were evaluated on postoperative days 1,4, and 6. Results: Early nutritional support was associated with a significant improvement in NE and IGF-I (Repeat measures analysis of variance IGF-I, P <.001. and NE P<.01). Conclusions: The authors conclude that early parenteral nutrition has a positive effect on the anabolic response as shown by improved NE and higher IGF-I levels in pediatric patients after major surgery. J Pediatr Surg 34:1330-1335. Copyright (C) 1999 by W.B. Saunders Company.