No abstract

The resting metabolic expenditure of seven allogeneic marrow transplant patients supported by total parenteral nutrition was monitored by respiratory indirect calorimetry using a portable apparatus with a plexiglass canopy. The averaged measurements of resting metabolic expenditure using indirect calorimetry were highly correlated with calculated basal energy expenditures, ideal body weights, fat‐free weights, and actual body weights. No consistent correlation was demonstrated between resting metabolic expenditure and body temperature. It is concluded that indirect calorimetry using a portable system is feasible and that measurements of energy expenditure so obtained correlate well with calculated estimates employing the basal energy expenditure equation.

Oral food tolerance is compromised by drug and radiation therapy administered to patients undergoing bone marrow transplantation for hematological malignancy or aplastic anemia. Resultant decreases in oral fat intake coincident with fat-free parenteral nutrition may predispose patients to essential fatty acid (EFA) deficiency. Determinations were made of the fatty acid composition of plasma total lipid from 20 bone marrow transplant patients on admission, at the time of bone marrow transplant, and on days 7, 14, 30, and 60 post-bone marrow transplant. Patients ate ad libitum but with little appetite and received fat-free parenteral nutrition interrupted for numerous blood product and drug infusions. Abnormal EFA status was manifest (20:3 omega 9/20:4 ratio greater than 0.2) in 12 of 20 patients during the course of treatment. Plasma EFA status was consistently correlated with oral fat intake but not with sex, age, percentage of ideal body weight, or amount of plasma infused. This suggests that dietary fat was absorbed limiting the severity of EFA deficiency. Interruptions of glucose infusion averaging only about 2 hours/day, also may have helped moderate the deficiency.