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Improvement in amino acid utilization in the critically ill with parenteral formulas enriched with branched chain amino acids
IMPROVEMENT IN AMINO ACID UTILIZATION IN THE CRITICALLY ILL WITH PARENTERAL FORMULAS ENRICHED WITH BRANCHED CHAIN AMINO ACIDS M.M. Echeni ue B. R. Bistrian, L. L. Moldawer, J. D. Palombo, M. J. e Blackburn New England Deaconess Hospital, Nutrition/Metabolism Lab, Harvard Medical School, Boston, MA. 02215, USA To assess the value of branched chain amino acid enriched solutions in stressed patients, five critically ill individuals in the intensive care unit requiring total parenteral nutrition were studied. Two complete feeding solutions were compared: one containing 15.6% of the amino acids as branched chain amino acids and the other containing 50% of branched chain amino acids. The isocaloric and isonitroaenous solutions were intravenously administeredfor 24 hours sequentially-and during the last then hours of each infusion, 50 uCi of L-(1-I4C)-leucine were added to the infusate to estimate leucine kinetics. Results showed increases in leucine flux (from 3.92 + 0.48 mmols/hr to 6.26 + 0.51, pt0.05), and net leucine balance from (+.048 + 0.23 to t1.41 t 0.33 mmols/hr, p
P62 THE EFFECT OF ECAA CONCENTRATION OF TPN MIXTURE ON NITROGEN SPARING IN POSTOPERATIVE CATABOLISM A. Kari, K. Hersio, M. Laitinen, I. Penttill, M. Pdyhdnen. Kuopio University Central Hospital, Finland It has heen shown in several exnerimental and clinical studies. that high amounts of branched chain amino acids (BCAA) reduce the postooerative orotein loss. The comoarison was made between two widelv used amino acid'mixtures having different concentrations of BCAA (Vami‘;lR, BCAA 19.1 % and Freamine IIR. BCAA 23.3 %1 and a new mixture containina 29.2 % BCAA (Levamin 80) in-the treatment of postoperative catabolism: 30 patients undergoing gastric or colin resections were randonized into the three treatment groups according to the type of operation, nutritional status and weight. Amino Acid mixtures were infused over four postoperative days (12,4 g nitrogen/day) together with hypocaloric amount of glucose (1600 kcal/day). There was no significant difference between the groups in daily or cumulative nitrogen balances during the study. The concentration of prealbumin in serum decreased in each treatment group but there was no significant difference between the groups. Moderate increase in BCAA concentration of amino acid mixture did not produce a favourable effect on protein metabolism during postoperative TPN when nitrogen balance and prealbumin were chosen as cirteria of the comparison.
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P62 THE EFFECT OF ECAA CONCENTRATION OF TPN MIXTURE ON NITROGEN SPARING IN POSTOPERATIVE CATABOLISM A. Kari, K. Hersio, M. Laitinen, I. Penttill, M. Pdyhdnen. Kuopio University Central Hospital, Finland It has heen shown in several exnerimental and clinical studies. that high amounts of branched chain amino acids (BCAA) reduce the postooerative orotein loss. The comoarison was made between two widelv used amino acid'mixtures having different concentrations of BCAA (Vami‘;lR, BCAA 19.1 % and Freamine IIR. BCAA 23.3 %1 and a new mixture containina 29.2 % BCAA (Levamin 80) in-the treatment of postoperative catabolism: 30 patients undergoing gastric or colin resections were randonized into the three treatment groups according to the type of operation, nutritional status and weight. Amino Acid mixtures were infused over four postoperative days (12,4 g nitrogen/day) together with hypocaloric amount of glucose (1600 kcal/day). There was no significant difference between the groups in daily or cumulative nitrogen balances during the study. The concentration of prealbumin in serum decreased in each treatment group but there was no significant difference between the groups. Moderate increase in BCAA concentration of amino acid mixture did not produce a favourable effect on protein metabolism during postoperative TPN when nitrogen balance and prealbumin were chosen as cirteria of the comparison.
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