Nutritional support after open heart surgery
Kumon, K.; Tanaka, K.; Isobe, F.; Kishimoto, Y.; Takahara, Y.; Naito, Y.; Fujika, T.
Nihon Kyobu Geka Gakkai 30(7): 1227-1234
1982
ISSN/ISBN: 0369-4739 PMID: 6816870 Document Number: 191337
The present study estimated energy expenditures in the postoperative period and attempted to make minimum requirement guidelines for nutritional repletion. Of 49 patients who had received open heart surgery and required artificial ventilatory support for > 4 days, 26 patients were adult (.gtoreq. 15 yr old), 7 were children (1-15 yr old) and another 13 were infants (< 1 yr old). The body weight of these patients were significantly lower than standard body weight (SBW), where percent of SBW was 92.7 .+-. 1.42 (mean .+-. SD)% in adults (P < 0.02), 74.5 .+-. 14.6% in children (P < 0.001) and 62.6 .+-. 10.4% in infants (P < 0.001). Stress index was obtained in adult cases. Daily energy expenditure was estimated by O2 uptake, which was calculated from cardiac output and arterial-mixed venous difference of O2 concentration according to Fick's principle. Total daily protein loss was estimated by N loss, which was defined by daily urinary urea excretion, daily change in plasma urea and daily obligatory N loss. Stress indexes were positive in most of patients and were > 5 in the majority throughout the study period, showing the presence of severe stress. Total daily energy expenditure was 26.5 .+-. 11.9 cal/kg per day in adults, 67.3 .+-. 11.9 cal in chidlren and 69.5 .+-. 13.2 cal in infants. Total daily protein loss was 2.12 .+-. 0.65 g/kg per day in adults, 1.52 .+-. 0.32 g in children and 1.45 .+-. 0.75 g in infants. To spare energy expenditure and protein catabolism after open heart surgery, it is recommended to provide 30 cal/kg per day using 2.0 g of amino acids/kg per day in adults and 70 cal/kg per day using 1.5 g of amino acids/kg per day in children and infants.