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Nitrogen Balance in Parenteral Nutrition-Reply

Charles W. Van Way III, MD
Arch Surg. 1975;110(10):1256. doi:10.1001/archsurg.1975.01360160094022.
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In Reply.—We would like to thank Drs Rowlands and Clark for their comments. We normally recommend at least 12 gm of nitrogen and 2,700 calories per day in the average adult patient (0.17 gm/day per kilogram of body weight and 38.6 kcal/day per kilogram of body weight). Our data showed that positive nitrogen balance was observed in five of nine patients receiving an average of 10.5 gm/day of nitrogen and 2,345 kcal/day. One patient had a nitrogen intake of only 8 gm/day and a caloric intake of 1,800 kcal/day, yet was in positive nitrogen balance. The discrepancy between the experience of Drs Rowlands and Clark and our experience simply points out the extreme variability in nutritional requirements, and the fallacy of drawing hard and fast rules in this area.

Nitrogen loss in control patients ranged from 4.14 to 9.27 gm/day, with a mean of 6.88. The usual range quoted


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