Plasma proteins in patients receiving intravenous amino acids or intravenous hyperalimentation after major surgery.

Eleven plasma proteins were compared for each of three groups of 10 closely matched patients before and 15 days after rectal excision who were receiving an addition to oral diets the following parenteral solutions by central venous catheter: 1) no hyperalimentation, 2) hypertonic glucose plus amino acids, or 3) amino acids alone. Plasma transferrin, prealbumin, and retinol-binding protein were normal before surgery in all but seven patients. Postoperatively, concentrations were decreased, but were restored to normal after full hyperalimentation whereas they were significantly less and lower than normal in controls and patients receiving amino acids. Acute phase proteins were higher than normal before surgery and also 15 days later. Lower values in patients receiving hyperalimentation were mainly due to hydration compared with higher values in the other groups caused by the higher incidence of sepsis. It is concluded that full hyperalimentation after major surgery restores "visceral" proteins more rapidly than by infusion of amino acids alone and is associated with fewer clinical complications.