McCowan et al.
61
compared hypocaloric PN (1000 kcal, 70 g of
protein, and no lipid) with standard PN (25 kcal · kg
⫺1
· d
⫺1
with
lipid, 1.5 g/kg) and found a trend toward fewer infections (P ⫽
0.2) in the hypocalorically fed group. Interestingly, the incidence
of hyperglycemia in both groups was similar. Another hypothesis,
not proved in human subjects, is that bacterial translocation in the
setting of gut atrophy, secondary to its disuse with PN, is respon-
sible for the increased risk of infection seen with PN