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Related Experiment Videos

Branched chains support postoperative protein synthesis.

F B Cerra, D Upson, R Angelico

    Surgery
    |August 1, 1982
    PubMed
    Summary
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    Branched-chain amino acid (BcAA)-enriched total parenteral nutrition (TPN) improved nitrogen balance in surgical patients. This BcAA-TPN likely stimulates protein synthesis, offering a new way to manage metabolic stress.

    Area of Science:

    • Metabolic Medicine
    • Surgical Nutrition
    • Clinical Trials

    Background:

    • Patients undergoing major surgery or with trauma experience significant metabolic stress.
    • Standard total parenteral nutrition (TPN) may not optimally support protein synthesis during the early postoperative period.

    Purpose of the Study:

    • To compare the effects of branched-chain amino acid (BcAA)-enriched TPN versus standard TPN.
    • To evaluate the impact on nitrogen balance and protein metabolism in surgical and trauma patients.

    Main Methods:

    • A blinded, prospective trial was conducted.
    • Participants included nonseptic, noncirrhotic abdominal surgery patients and those with multiple traumatic injuries.
    • Nutritional interventions were isocaloric and isonitrogenous over a 7-day postoperative period.

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    Main Results:

    • BcAA-enriched TPN led to a positive nitrogen balance by day 3.
    • Urinary nitrogen output decreased by day 3 in the BcAA-TPN group.
    • Plasma BcAA levels rose by day 6, with no change in 3-methylhistidine excretion, suggesting stimulated protein synthesis.

    Conclusions:

    • BcAA-enriched TPN favorably modulates the metabolic stress response post-surgery and trauma.
    • Early nitrogen retention with BcAA-TPN indicates a potential for enhanced protein synthesis.
    • Alternate fuel strategies, like BcAA-TPN, are becoming clinically viable for managing metabolic stress.