J.Jpn. Surg. Soc.. 54(4): 283-297, 1953

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Original article

Part II. POSTOPERATIVE STUDIES

Relationships between the postoperative nitrogen metabolism and water balance, circulatory state and hepatic function are here observed. According to this result the auther discuss the postoperative clinical course and the underlying problems of postoperative nutrition.
1. Postoperative urinary elimination of nitrogen varies with the preoperative nutritional state and magnitude of surgical stressors.
2. Average intakes of calories and protein are related proportionally with the cumulative nitrogen status during 3 postoperative pays. The degree of catabolism in this "catabolic phase'' may be decreased by a certain amount with the augmentation of caloric and protein intake. As circulatory disorders, tissue anoxia and lowering of utilization rate of protein are complicated more or less in this period, so it might questioned whether positivity of nitrogen balance can be obtained in this phase or not.
3. There can be found no conspicuouces changes in postoperative urinary elimination of uric acid, creatine and phosphoric acid. Potassium output parallels with nitrogen output, a positive balanee of potassium is attained after oral feeding begins.
4. Postoperative hepatic dysfunction is restored after 5th day when circulatory disorder is corrected, caloric and protein intake is incieased.
5. The metabolism of postopeaative 3rd or 5th days period is catabolic in nature. And it is utmost important in this period to correct at first the abnormality in water balance and to restore the circulatory disorder. After the suitable hydration is given, then calories and protein may be supplemented as much as possible. (author's abstiract)

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