Oral nutrition in patients receiving home cyclic parenteral nutrition: pattern of substrate utilization

Patients receiving cyclic home parenteral nutrition (PN) often have a significant oral caloric intake. This study describes the metabolic use offuels, as assessed by indirect calorimetry. in eight stable. ambulatory, noncancerous, adult patients receiving glucose-based PN with (PN + oral) or without (PN only) a self-selected oral intake. Patients’ weight was 91 ± 2 (i ± SE) of ideal body weight, and fat mass was 22 ± 5 and 3 1 ± 2% of actual body weight in males and females, respectively. Under the PN-only regimen, providing 104 ± 5% of predicted basal energy expenditure (BEE), patients were in equilibrium for energy and nitrogen balances. Oral supplementation (absorbed oral intake 80 ± 5% of BEE) was associated with positive energy and nitrogen balances but also with nearly continuous net fat synthesis. We conclude that the glucose-based PN + mixed oral regimen enables the patients to face the increased energy requirements ofeveryday ambulatory life but is not associated with an optimal body composition in long-term PN patients. Am J C/in Nutr 199 l;54:560-4.