[Comparative study of a new commercially produced combination solution (fat, carbohydrates, aminoacids) for complete parenteral feeding of surgery patients in intensive care].

In 10 randomly selected surgical ICU patients, a new regimen of total parenteral nutrition (TPN) using a so-called all-in-one (AIO) solution was tested prospectively. Another 10 patients receiving conventional TPN served as a control group. For a minimum of 7 days the patients were given either an AIO solution containing 40 g crystalline L-aminoacids, 38 g fat, 75 g sorbitol and 45 g xylitol in 1000 ml or a conventional TPN with glucose and aminoacids. The regimens were identical regarding caloric intake and Joule/N ratio. Amounts of infused solutions were adjusted according to patient's weight. Both regimens were well tolerated and side effects requiring interruption of the protocol did not occur. A set of 36 laboratory parameters underwent detailed statistical analysis. Efficiency of both regimens in improving nutritional status was documented. Comparing the two groups, we found only two important differences: glucose levels in the AIO group were lower than in the control group, and the bilirubin increase observed in both groups (probably a sign of cholestasis) was higher in AIO patients. Immediate postoperative or posttraumatic nutrition with an AIO solution was safe and simple to administer. Because glucose metabolism is only minimally overstrained, AIO compares favorably with conventional TPN and is a promising alternative when stress-induced glucose intolerance occurs.