[Role of new nitrogen substrates during peri-operative artificial nutrition in adults]

Some amino acids and their derivatives, such as arginine (ARG), glutamine (GLN) in free form or as dipeptides, and ornithine-ketoglutarate (OKG), have specific pharmacological properties concerning namely immunomodulation, control of protein turn-over, maintenance of gut trophicity. In the context of the postoperative nutrition in the adult, supplementation of enteral nutrition with ARG and of parental nutrition with GLN and OKG has improved nutritional and biochemical markers such as nitrogen balance, muscle protein synthesis and glutamine content. However, only few studies have tried to demonstrate a clinical benefit with such a supplementation. At present only the beneficial effect of OKG on postoperative wound healing has been recognized.