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Published on: September 20, 2019
Amino acids - Guidelines on Parenteral Nutrition, Chapter 4
J Stein1, H J Boehles, I Blumenstein
1Dept. Internal Medicine, University of Frankfurt, Germany.
German Medical Science : GMS E-Journal
|January 6, 2010
Summary
Parenteral nutrition (PN) requires amino acid (AA) solutions to reduce protein breakdown and boost synthesis. Specific AA formulations and dosages are recommended based on patient metabolism and conditions, ensuring optimal nutrient utilization.
Area of Science:
- Clinical Nutrition
- Metabolic Disorders
- Parenteral Nutrition
Background:
- Parenteral nutrition (PN) necessitates strategies to minimize protein catabolism and enhance protein synthesis.
- Amino acid (AA) solutions are integral to PN, with standard and specialized formulations available.
- Appropriate AA intake and energy provision are crucial for effective nutrient utilization in PN.
Purpose of the Study:
- To outline recommendations for amino acid (AA) administration in parenteral nutrition (PN).
- To define optimal AA dosages and nutrient-energy ratios for various patient populations.
- To clarify the role of specific amino acids (e.g., glutamine, arginine, BCAA) in PN.
Main Methods:
- Review of current guidelines and evidence regarding amino acid (AA) use in parenteral nutrition (PN).
- Analysis of recommended AA intake levels (g/kg/day) for adult patients with normal and critical metabolism.
- Evaluation of nitrogen-to-calorie ratios and the use of specialized AA solutions.
Main Results:
- General AA intake recommendation for adults is 0.8 g/kg/day, adjustable to 1.2-2.5 g/kg/day based on metabolic status.
- Recommended nitrogen-to-calorie ratios range from 1:130 to 1:170 (g N/kcal) or 1:21 to 1:27 (g AA/kcal).
- Specific recommendations exist for glutamine in critically ill patients and BCAA-enriched solutions for hepatic encephalopathy.
Conclusions:
- Parenteral nutrition (PN) requires careful selection and dosing of amino acid (AA) solutions for optimal patient outcomes.
- Specialized AA formulations are indicated for specific metabolic conditions and critical illnesses.
- Further research is needed to establish definitive recommendations for certain amino acids (e.g., arginine) and patient groups.
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