Intravenous Hyperosmolar Alimentation

The value of nutrition in surgery has been well appreciated for the past two decades. Although it has become increasingly obvious that protein metabolism often plays a decisive role in the final outcome of patients who have undergone surgery, it has rarely been possible to obtain a state of positive nitrogen balance following major surgical procedures. Since many investigators have shown that it takes approximately 150 nonprotein calories to spare 1 gm of nitrogen, it was thought impossible to obtain positive nitrogen balance by parenteral routes because of the hypertonic solution required. Recently, Dudrick et al^1-3 raised six Beagle puppies to full growth, utilizing only intravenous alimentation. High doses of carbohydrate and protein hydrolysate were infused to supply adequate calories and protein factors. Subsequently, Dudrick et al have supported many patients having serious chronic gastrointestinal disease with intravenous alimentation and have established a positive nitrogen balance in each.^4-7