[Changes of plasma amino acid on the course of septic multiple organ failure]

The changes of plasma amino acid (AA) pattern on the course of septic multiple organ failure (SMOF), and the effect of branched chain amino acid enriched solution (BCAA-S) on the AA pattern were evaluated in thirteen patients who died of SMOF in ICU. The course of ICU was divided into the following three stages. Stage I was a few days after the admission in ICU. Stage II was severe infected state. Stage III was terminal state. Following results were obtained: 1) Total AA value (TAA) of each stage was 2,693 n.mol/ml, 6,666 n.mol/ml and 19,480 n.mol/ml. 2) BCAA/aromatic AA (B/A) of each stage was 1.4, 1.03 and 1.05. Above values were lower than those of normal one (2.44). 3) Most kinds of AA in stage III were exhibited significantly higher than those of stage I as evaluated in absolute value. 4) In the BCAA-S administered group, B/A exhibited higher values than those of control, but, there was no sign of amelioration for SMOF condition in the former group. In severe infected or septic shock state, AA metabolism is deeply deteriorated. So, we can not decide whether BCAA-S given in this condition plays beneficial effect on the course of SMOF or not.