[Multiple system organ failure in postburn: characteristics of plasma amino acid profiles]

The purpose of this study was to investigate the levels of various plasma amino acids in 30 burned patients (76.83 +/- 14.4% TBSA, with III. 42.16 +/- 27.95% TBSA) and identify the alterations in plasma profiles characteristic of patients who later developed MSOF (n = 16) versus those who did not developed MSOF (n = 14). The levels of amino acids were analyzed by use of individual amino acid and the ratio of BCAA (Branched-Chain Amino Acid) to AAA (Aromatic Amino Acid) and Phe to Tyr. The results showed that: (1) The patients who developed MSOF later had significantly lower levels of Pro, Gly Arg, Val, Leu, Ile, and BCAA/AAA, and higher values of Phe, Trp, Tyr, and Phe/Tyr than those who did not develop MSOF. (2) The incidence rate of MSOF increased as the ratio of BCAA/AAA decreased. When the ratio lower than 1.5, eight of ten patients developed MSOF. (3) The higher of the values of Phe/Tyr, the more of the incidence of MSOF. When Phe/Tyr was higher than 2.0, six of seven developed MSOF. These data suggested that: (1) Both BCAA/AAA and Phe/Tyr were the indices of prognosis available in severe trauma patients. (2) Alterations in metabolism as reflected in plasma amino acids patterns were thus critical indicators of MSOF. (3) Liver may be the earliest involved and the most severe injured organ in multiple system organ failure.