[Metabolic and nutritional support in severely burned patients]

Proper metabolic and nutritional support is an important treatment modality in severely burned patients. We examined the effect of branched-chain amino acid (BCAA) enriched TPN on metabolism of burned rats. A scald injury (30% BSA) was produced in rats. The rats, after resuscitated with saline for 24 hr, were divided into 3 groups.

received saline. Group B: received TPN with BCAA enriched solution (45% BCAA). Group C: received TPN with conventional amino acid solution (21.3% BCAA). Both of these TPN solutions were isocaloric and isonitrogenous. Rats of each group were administered TPN solution or saline for further 48 hr. The metabolites in the liver and muscle were measured. Rapid and marked decrease of levels of metabolites such as adenine nucleotides, glycogen, G-6-P, protein and RNA/DNA was observed in the liver and muscle of the rats during fluid resuscitation. The rats of group B showed significant recoveries in all of these parameters after administration of the TPN, as compared with those of group C. On the other hand, progressive metabolic deterioration was recognized in the rats of control group. These results indicate beneficial effects of BCAA enriched TPN on energy and protein metabolism in scald injury.