[Effect of branched chain amino acid (BCAA) enriched solution in postoperative patients receiving TPN]

Validity of branched chain amino acid (BCAA) enriched solution in surgical stress was assessed using total catecholamine excretion (U-CA) as the severity in dex. Thirty percent BCAA solution was infused no 21 patients (T group), and 21% BCAA to 18 patients (P group) pre and postoperatively. 2.0 g protein and 35 kcal/kg.day were provided by total parenteral nutrition (TPN). Correlation of nitrogen-balance to U-CA was statistically significant in both groups (p less than 0.01). The difference of correlations was statistically significant when analyzed by covariance (p less than 0.05). Rapid turnover proteins were significantly higher in T group, but no difference of urinary 3-methylhistidine excretion was observed. Increased uptake of BCAA and release of glutamine and alanine by skeletal muscle were observed. However, no alteration in arterio-venous difference of phenylalanine and tyrosine was detected. In conclusion, 30% BCAA solution significantly improved postoperative protein metabolism, probably due to the improved visceral protein metabolism supported by amino acid supply by skeletal muscle.