[Parenteral administration of amino acids to septic patients]

The study investigates the status of plasma amino acids and their pathological changes under the specific conditions of sepsis in 20 intensive care patients, who were randomized into two groups with and without amino acid support. The study was designed to determine whether the concentration of the free amino acids in plasma or their relative proportions to each other determine the cellular uptake under septic conditions in such a way that would have relevance for the exogenous supply. Sepsis was defined as an increase in body temperature above 38 degrees C, a positive blood culture and changes in the white blood cell picture. Carefully standardized and quality-controlled low-pressure liquid chromatography was used along with a new procedure for data processing, based on personal physiological range with known ranges for individual amino acids. The concentrations of individual amino acids vary widely and did not allow a decision to be made about disturbance of homeostasis. The mean total concentrations varied between 1.27 mmol/l and 4.40 mmol/l. The range was similar whether amino acids were administered or not. This variation was also found in the branched chain amino acids, which were considered to have a specific importance in septic states. Valine varied between 114 mumol/l. The relative proportion of the individual amino acids to the whole amount of amino acids showed less variation and demonstrates that the oxidative action of the liver is able to correct any deviation from the normal and maintains the uptake of amino acids by the cells.(ABSTRACT TRUNCATED AT 250 WORDS)