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Naftidrofuryl, exogenous energy substrates and the metabolic response to surgery

Naftidrofuryl, exogenous energy substrates and the metabolic response to surgery
Naftidrofuryl, exogenous energy substrates and the metabolic response to surgery

A major metabolic effect of injury is to increase the net degradation of muscle proteins to provide precursors for alternative energy substrates and maintain synthesis of visceral and acute phase proteins. Loss of a small proportion of total body protein is probably inevitable and in the majority of cases causes little harm. However, if the injury is severe, the response to it prolonged and the nutritional intake inadequate, then wasting of muscle proteins is marked and the immune system and healing process are compromised resulting in increased morbidity.

Recently, there has been much interest in the possibility of pharmacological manipulation of the metabolic response to injury and previous work had suggested that naftidrofuryl oxalate may improve nitrogen balance following elective abdominal surgery.

Studies in this thesis investigated the effect ofnaftidrofuryl oxalate on the metabolic response to elective abdominal surgery in patients who received a peripheral intravenous infusion of dextrose-saline(25 kJ kg-1 day-1) or isotonic amino acids only (0.15 g nitrogen kg-1 day-1) or a central venous infusion of glucose (50 kJ), amino acids (0.15 g nitrogen) and fat (50 kJ) kg-1day-1.

The infusion of 200 mg naftidrofuryl oxalate twice daily resulted in attenuation of the expected post-operative rise in venous blood lactate and pyruvate concentrations and also in reduction of the lactate to pyruvate ratio in the glucose-containing infusion regimens. However, these potentially beneficial changes were not associated with any effects on other intermediary metabolites or the daily or cumulative 3 and 6-day nitrogen balance.

Comparison of the three infusion regimens showed that the provision of isotonic amino acids only resulted in increased ureagenesis with no improvement in nitrogen balance compared to the dextrose-saline infusion. The provision of glucose, amino acids and fat resulted in great improvement in nitrogen balance compared to the other two infusion regimens, thereby confirming the beneficial use of such an infusion.

University of Southampton
Khawaja, Hamid Tannous
a1fbe012-e43f-44cf-9278-84b556eedb50
Khawaja, Hamid Tannous
a1fbe012-e43f-44cf-9278-84b556eedb50

Khawaja, Hamid Tannous (1987) Naftidrofuryl, exogenous energy substrates and the metabolic response to surgery. University of Southampton, Masters Thesis, 320pp.

Record type: Thesis (Masters)

Abstract

A major metabolic effect of injury is to increase the net degradation of muscle proteins to provide precursors for alternative energy substrates and maintain synthesis of visceral and acute phase proteins. Loss of a small proportion of total body protein is probably inevitable and in the majority of cases causes little harm. However, if the injury is severe, the response to it prolonged and the nutritional intake inadequate, then wasting of muscle proteins is marked and the immune system and healing process are compromised resulting in increased morbidity.

Recently, there has been much interest in the possibility of pharmacological manipulation of the metabolic response to injury and previous work had suggested that naftidrofuryl oxalate may improve nitrogen balance following elective abdominal surgery.

Studies in this thesis investigated the effect ofnaftidrofuryl oxalate on the metabolic response to elective abdominal surgery in patients who received a peripheral intravenous infusion of dextrose-saline(25 kJ kg-1 day-1) or isotonic amino acids only (0.15 g nitrogen kg-1 day-1) or a central venous infusion of glucose (50 kJ), amino acids (0.15 g nitrogen) and fat (50 kJ) kg-1day-1.

The infusion of 200 mg naftidrofuryl oxalate twice daily resulted in attenuation of the expected post-operative rise in venous blood lactate and pyruvate concentrations and also in reduction of the lactate to pyruvate ratio in the glucose-containing infusion regimens. However, these potentially beneficial changes were not associated with any effects on other intermediary metabolites or the daily or cumulative 3 and 6-day nitrogen balance.

Comparison of the three infusion regimens showed that the provision of isotonic amino acids only resulted in increased ureagenesis with no improvement in nitrogen balance compared to the dextrose-saline infusion. The provision of glucose, amino acids and fat resulted in great improvement in nitrogen balance compared to the other two infusion regimens, thereby confirming the beneficial use of such an infusion.

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Khawaja 1987 Thesis - Version of Record
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More information

Published date: 1987
Additional Information: Master of Surgery (MS)

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Local EPrints ID: 473905
URI: http://eprints.soton.ac.uk/id/eprint/473905
PURE UUID: 274ed1ad-72b6-4670-b815-9373faf6555c

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Date deposited: 03 Feb 2023 17:31
Last modified: 17 Mar 2024 00:38

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Author: Hamid Tannous Khawaja

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