Use of selected visceral protein measurements in the comparison of branched-chain amino acids with standard amino acids in parenteral nutrition support of injured patients

D. A. Kuhl, R. O. Brown, K. L. Vehe, Bradley Boucher, R. W. Luther, K. A. Kudsk

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Twenty injured patients in the intensive care unit were randomized to receive parenteral nutrition with either 21% (STD) or 46% (HBC) branched-chain amino acids to compare the response of nitrogen balance (NB), somatomedin-C/insulin-like growth factor I (SMC), circulating fibronectin (FBN), and prealbumin (PA). NB was measured and serum collected for SMC, FBN, and PA on days 1, 4, 7, 14, and 21 of nutritional intervention. The treatment groups did not differ significantly for age, weight, injury severity score, trauma score, Apache II score, acute-phase protein concentrations, or type of injury. Comparison of baseline measurements revealed no significant differences in SMC, FBN, or PA. Both groups received similar doses of nonprotein energy and nitrogen. Baseline urea nitrogen excretion was slightly higher in the STD group (216 ± 55 vs 268 ± 54 mg/kg/day p = 0.049). Although NB was significantly improved over baseline during subsequent study days, there were no differences between groups after the day-1 measurement. SMC increased significantly from baseline on day 4 in the STD group, on day 7 in the HBC group, and on days 14 and 21 in both groups. There was no significant difference in SMC concentrations between groups on any day. Each group demonstrated a significant increase in PA from baseline on days 7, 14, and 21; however, no difference was seen when groups were compared. FBN increased significantly from baseline on day 14 in the HBC group and on days 7 and 14 in the STD group. FBN measurements were significantly different between groups on day 14 (STD, 179 ± 71 vs HBC, 229 ± 59 μg/ml; p < 0.05). NB, PA, SMC, and FBN improve significantly during parenteral nutrition of traumatized patients. With the measured variables, there appears to be no significant difference between STD or HBC amino acids when used as part of parenteral nutrition in injured patients.

Original languageEnglish (US)
Pages (from-to)503-510
Number of pages8
JournalSurgery
Volume107
Issue number5
StatePublished - 1990

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Branched Chain Amino Acids
Parenteral Nutrition
Sexually Transmitted Diseases
Prealbumin
Fibronectins
Nitrogen
Amino Acids
Proteins
Insulin-Like Growth Factor I
Injury Severity Score
Acute-Phase Proteins
Wounds and Injuries
Intensive Care Units
Urea
Weights and Measures
Serum

All Science Journal Classification (ASJC) codes

  • Surgery

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Use of selected visceral protein measurements in the comparison of branched-chain amino acids with standard amino acids in parenteral nutrition support of injured patients. / Kuhl, D. A.; Brown, R. O.; Vehe, K. L.; Boucher, Bradley; Luther, R. W.; Kudsk, K. A.

In: Surgery, Vol. 107, No. 5, 1990, p. 503-510.

Research output: Contribution to journalArticle

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abstract = "Twenty injured patients in the intensive care unit were randomized to receive parenteral nutrition with either 21{\%} (STD) or 46{\%} (HBC) branched-chain amino acids to compare the response of nitrogen balance (NB), somatomedin-C/insulin-like growth factor I (SMC), circulating fibronectin (FBN), and prealbumin (PA). NB was measured and serum collected for SMC, FBN, and PA on days 1, 4, 7, 14, and 21 of nutritional intervention. The treatment groups did not differ significantly for age, weight, injury severity score, trauma score, Apache II score, acute-phase protein concentrations, or type of injury. Comparison of baseline measurements revealed no significant differences in SMC, FBN, or PA. Both groups received similar doses of nonprotein energy and nitrogen. Baseline urea nitrogen excretion was slightly higher in the STD group (216 ± 55 vs 268 ± 54 mg/kg/day p = 0.049). Although NB was significantly improved over baseline during subsequent study days, there were no differences between groups after the day-1 measurement. SMC increased significantly from baseline on day 4 in the STD group, on day 7 in the HBC group, and on days 14 and 21 in both groups. There was no significant difference in SMC concentrations between groups on any day. Each group demonstrated a significant increase in PA from baseline on days 7, 14, and 21; however, no difference was seen when groups were compared. FBN increased significantly from baseline on day 14 in the HBC group and on days 7 and 14 in the STD group. FBN measurements were significantly different between groups on day 14 (STD, 179 ± 71 vs HBC, 229 ± 59 μg/ml; p < 0.05). NB, PA, SMC, and FBN improve significantly during parenteral nutrition of traumatized patients. With the measured variables, there appears to be no significant difference between STD or HBC amino acids when used as part of parenteral nutrition in injured patients.",
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