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Nutrition in orthopaedic surgery JE Jensen, TG Jensen, TK Smith, DA Johnston and SJ Dudrick J Bone Joint Surg Am. 1982;64:1263-1272.
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The Journal of Bone and Joint Surgery 20 Pickering Street, Street, Needham, MA 02492-3157 www.jbjs.org
Surgery Volume VoLUME
98
Copyright
From
he
D iviv i o n
by
Th
Journal
Jont
Suge
n co co rp rp o a t
of
ABSTRACT:
undergoing ment.
50
(28.6 (35.3
zation
(586
8,26.28.:ta.36
0.05)
described.
ar an
such
of
We
Association, Columbia
mb
65205. #{176}.
University
77030.
in
tigators
1,3,7,11,26
of
( 1
Th minimum,
T
of
c r m lo lo n
me
o f O lele c
Ar
m us c l
c i c um u m fe f e re re nc nc e
cm)
Ar
c ir i r cu c u m fe f e re re n c e FIG.
10.314
c ep s
on
s k n fo fo l
mm)
i d n titi fif i c t i
1265
m pl pl i
anthropometric
io
biochemical lU were
56.9
at
13O,32#{149} 13O,32# {149}
Group
creatinine:height
17
(Fig
Th
c r t in in in in e: e: h i gh gh t trauma
Visceral
trations42O2lf43
mass
TABLE CRITERIA
Index T r c ep ep s
s k n fo fo ldld *
A rm rm -m - m u sc sc l
to
c i c um u m fe fe re r e n ce ce
C re re a t n in in e h e g h a ns ns fefe r
10
n de de x 15
o n e n a to n
(mg/d!) to
3.
.0
(gidi) 1000
(cells/mm
protein. Sk
an mm
3)
en n du d u ra ra t o n
es
1000
1266 TABLE AR
II ME
Ag
Triceps
5 -3 -3 5
s.
ME
ME
Arm
kinfold
Arm-Muscle
Circuniference
(trim)
Circumference
(un)
(ePri)
15 1000 -:
er
tion). wa
Group
th he ur-
Results 3057),
9.
19).
of .5 80
11
Th
of
triceps
56
TRANS
serum
e: ei
1267
MODERATE
Group
up All
II Femoral
38 54
c om om p e te te l
e va va l
ed t
n de de x
index
(n
l
e p e te te d
depleted) n de de x
e p e te te d
1:
p0
rauma
.35
15
(p
0.002).
.001)
circumference
VOL.
to
68
;.
PL
O NS NS *
(omplication
1
0 10
27
0 2
10
Sepsis
1
Urinary
1 2
0
Cardiovascular Death Miscellaneous 99
e pe t
es
). 0.003).
patients
me
mp
mp
8.
54
20
10
1S FIG.
m -m -m u c l tWo
ci um
ce
1269
N FE FE cT cT IO IO u
C oM oM PL PL IC IC AT AT I N S
ELEcTivE Trauma ( N = 55) 5 5)
Replacement
Index
(N
Other
36
(N 12
A rm rm -m -m u
u m e re re n e
16.
5. .
Albumin
(g/dl)
0.
2.
0.003
standard)
100%
(<65sf
1 0.08
s t a n da da r d )
Transfemn
0.03
(Keal)
1 6 22 .
i n t a k e( g )
Nitrogen
1649.2
100
1109.9
no
.:
9.
7 1. 6
mgd
(<
t)
2. r ot e i n
7.
3.
15 tell.s,n,n
96.7
12
0.002
5.
0.003
1.
0.003
significant.
are
no
s ig n f ic an an t
Discussion
15).
0-
76.1
Moderate 67
Severe
57.4
38.9
Iifl
IB FIG.
Elective
(N74)
1270
c::i
75
oderate
Severe
45.9
FIG.
to
.5
surgeon
Therefore
mu
recent
surements
nd
d e e rm rm in in a o n
NUTRITION
1271
Layeiective
ee
operation
aattbu buamdm it n( n(isits3s.4 .4ioiogn/d /d l dm
s ee sru ruen em nt
wi
O b ta ta i nu
o na na l
c om om p le le t a ss s s e ss s s m en en t
srer eer us e n t ’t ra ratn st st er er r,r, n< n< 1 5
peration r ov ov id id esupport nlective u trtr it io na na l
P ro rooperation cw e ee wi nutrient i nt nt ak ak e n itit ro ro g e balance. s e ru ru m a lb lb um u m in in .
Mo
ym
ott1ollow,?
present’
dmini5ter d mini5ter n te te r a
s e ve ve r
ma nu
int ravenou
n u trtr itit io io n
yperalimentation
FIG.
clinical
situations
preoperative
0crash’
14 #{176}
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TH
JOURNAL
1720-