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Biomedical subjects

R Dölp

Publications and source records attributed to R Dölp.

At least 37 records · Page 2Linked to original sources
PubMed1978

[Clinical study on the concentration of free amino acids in plasma and urine during postaggression metabolism. I].

We studied the changes in the concentration pattern of free plasma amino acids in 30 surgical patients during standardized parenteral nutrition and exclusive water and electrolyte supply. Distinct reproducible differences were found in comparison to normal subjects. The concentration of branched-chain amino acids continuously increases during the post-operative period. The decrease of alanine is closely related. Phenylalanine also increases continuously due to insufficient transformation in the liver and increased release from the muscles. During post-aggression metabolism, cystine is probably not sufficiently formed from methionine and should be substituted. It may be that tyrosine is also essential for patients in the post-operative post-traumatic period. The glycine concentration of some amino acid mixtures is regarded as too high; the glycine content can be reduced in favour of serine supply.

Amino Acids, Essential↗
PubMed1978

[Clinical studies on the concentration of free amino acids in plasma and urine during post-aggression metabolism. II].

Our first report concerned the changes in the concentration of free plasma amino acids within the framework of postaggression metabolism, resulting from surgical intervention and parenteral nutrition. This study with 23 operated patients is intended to show whether an amino acid mixture is suited for parenteral nutrition if the particular metabolic action mentioned above is taken into consideration in the composition of the solution. We have shown that the change in the concentration of free plasma amino acids is very small during continuous infusion for 4 postoperative days in steady state and insignificant in comparison to the normal pattern of healthy subjects, except for phenylalanine. With a quota of 2.75% of the supply, the renal loss of free amino acids is clinically unimportant. We believe that an amino acid solution of such composition is suited for infusion in the postoperative and posttraumatic phase whereby our recommendation is explicitly limited to this indication.

Amino Acids↗
PubMed1978

[Possibilities and limitations of peripheral-venous parenteral feeding].

The possibilities of peripheral-venous nutrition as regards its substrate dosage are limited due to the vein tolerance (osmolarity) of the infusion mixtures. It is, therefore, imperative to achieve an optimum composition of the solution for obtaining the most favourable utilization rate for the organism. We have shown that a dosage below 0.6 g amino acids/kg BW per day does not have a positive influence on the nitrogen balance in comparison to a control group not nourished. The situation of a patient in the post-aggression phase results in 30 to 40% of the supplied amino acids being utilized in the energy metabolism and excreted as urea, in spite of a sufficient simultaneous energy supply. Not only does this uneconomical loss alone necessitate a higher amino acid dosage, but also the additionally increased catabolism of endogenous protein reserves in the post-operative phase. It remains to be tested whether the sole substitution of amino acids in a solution without carbohydrates over a short infusion period constitutes a compromise between the intended peripheral-venous tolerance and an effect on the nitrogen balance.

Amino Acids↗
PubMed1977

[Changes in amino acid concentrations in plasma after oral ingestion of oligopeptides and analogous amino acid mixtures].

To what extent an oligopeptide mixture differs in equimolar dosage from an equivalent amino acid mixture after oral intake was tested on 11 subjects. The plotted course and absolute order of magnitude of the two mixtures revealed no differentiation in the total amino acid concentration of the peripheral blood plasma. The same was true of the individual free amino acids in the plasma. The only difference was found in the graphic representation of the maximum amino acid concentration of the individual test subjects, which was usually reached at an earlier date with oligopeptides than with free amino acids. The difference is even more obvious in the portal vein, as is shown in a test series not yet completed, where the plasma amino acid concentration increased at a clearly earlier date after oligopeptide substitution than after the supply of the equivalent amino acid mixture.

Amino Acids↗
PubMed1977

[Starvation and surgical intervention].

The metabolic processes under conditions of stress and starvation are not identical. Moreover, they have to be differentiated, as far as carbohydrate-, fat- and amino-acid-metabolism are concerned, because both situations are not compatible. It is therefore required, to avoid any kind of starvation and particularly to substitute for adequate substrates during the pre- and postoperative period.

Amino Acids↗
PubMed1976

[Conditions for the efficacy of nutritional therapy].

This is to discuss regulatory mechanisms which enable the organism to respond optimally to special nutritive conditions. Those regulatory mechanisms are often in disorder with patients who need nutritive therapy. However, normal functions of the body are required for nutrition. Disarrangements in microcirculation, oxygen supply, water and electrolyte metabolism and acid-base metabolism are described and the way they will influence nutrition therapy. Furthermore, we try to describe special conditions of metabolism in stress and its influence to efficiency of nutritive therapy.

Acid-Base Equilibrium↗
PubMed1976

[Peripheral parenteral feeding during the postoperative stage (preliminary report)].

In various test series, the quantitative requirements for a parenteral basic nutrition of patients after moderately severe surgical trauma were investigated. The best results were achieved with a balanced infusion solution providing 1,800 kcal (greater than or equal to 7,540 kJ) and 75 g of amino acids (TPE 1800) per patient and day. A lower supply of amino acids and calories is obviously uneconomic. The solution was well tolerated also when it was infused via peripheral veins.

Amino Acids↗
PubMed1975

Suitability of non-glucose-carbohydrates for parenteral nutrition.

Postoperative parenteral nutrition can only be optimally effective if the characteristics of post-traumatic metabolism are taken into account. Two main possibilities are discussed for the carbohydrate component of parenteral nutrition during this phase: glucose with high doses of insulin or non-glucose carbohydrates (sugar substitutes) possibly in a suitable combination with glucose. The risks as well as the technical and organisational problems involved in the use of them are discussed and the authors prefer the second of the two alternatives. Possible side effects of non-glucose carbohydrates are pointed out and it is shown how these can be avoided by observing dose guidelines. So far a combination of frucose : glucose : xylitol in a ratio of 2 : 1 :1 with a total dose of 0.50 g/kg/hour has been studied most thoroughly. This combination normalises the fat metabolism and improves glucose tolerance without requiring exogenous insulin. Experiences with this combination as well as individual non-glucose carbohydrates on operated patients have been given continuously for up to 7 days and in some cases even for several weeks. No side effects, no deviations from a steady state and no abnormal changes of the laboratory values occurred. The authors are of the opinion that non glucose carbohydrates are necessary if the facilities for frequent blood sugar controls are not available.

Adenine Nucleotides↗
PubMed1975

[Significance of trace elements within the scope of parenteral feeding as illustrated on the example of the elements copper, zinc and chromium].

Biochemical function and biological significance of Cu, Zn and Cr are reviewed briefly. During a longterm perenteral nutrition a depletion of the organism of copper and zinc is to be expected. Therefore, in parenteral nutrition, an early substitution of zinc seems to be usefull. Up to now a similar recommendation for copper cannot be given. As many infusion solutions are contaminated with chromium, there is no need to substitute this element in parenteral nutrition.

Chemical Phenomena↗