Nitrogen requirements in severely injured patients

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Abstract
The study was designed to evaluate nitrogen needs in severely injured patients during the first week after trauma. Thirty‐nine patients aged from 18 to 65 years with a burn or fractures of more than two long bones were studied. Energy requirements were given par enter ally as fat and glucose in isocaloric amounts. The patients were randomized into five groups receiving different amounts of nitrogen from zero to 0·3 g kg body‐weight−1 24 h−1. Daily and cumulative nitrogen balance, urinary 3‐methylhistidine excretion and nitrogen retention were calculated on days 2–8 after trauma. With no nitrogen, the mean(s.e.m.) daily nitrogen balance after the trauma was ‐13·8(0·5) gN. The balance improved markedly in groups with a nitrogen intake of up to 0·2 g kg body‐weight−1 (P−1 24 h−1 is optimal for severely injured patients during the first week after trauma.