[Infusions of amino acid solutions in the therapy concept of trauma patients. Comparative studies in the early phase of polytrauma].
The early phase of injury is characterized, among other things, by enhanced proteolysis and changed protein synthesis. Posttraumatic catabolism with its negative nitrogen balance exercises a direct influence on the healing process. Our study aimed at finding out whether early application of complete parenteral feeding would improve protein metabolism. Two groups of patients were compared with one another: One group of test persons (n = 28) whom a complete solution (2.5 carbohydrate and 10% AA solution) was given directly after the injury, whereas a control group (n = 71) received parenteral feeding only from the first or second posttraumatic day. The serum levels of proteins and nitrogen loss in the urine served as parameters for the effectivity of infusion therapy, besides the determination of the serum glucose level (which was clearly lower than in the control group). A significant improvement was established in total protein and albumin (p less than 0.01) compared with the control group. Proteolytic activity, measured via the nonspecific plasma proteinase and alpha 1-antitrypsin activity, increases in the same measure as the protein level drops. Urea nitrogen also drops significantly, thus expressing better utilisability (p less than 0.005). Taking as basis a hypocaloric parenteral diet (5 mg./kg. body weight/min.) we can assume that the utilization of the amino acid intake will be optimal. It became evident that the selected ration of nitrogen-free to nitrogen-containing calory carriers was insufficient on the first posttraumatic day. Amino acids are required at an early stage after polytrauma to ensure rapid and complication-free regeneration of the patient.
Sefrin
P
P
Institut für Anaesthesiologie, Universität Würzburg.
Rupp
M
M
Hörl
W H
WH
D000209:Acute-Phase Proteins / Q000097:blood; D000596:Amino Acids / Q000008:administration & dosage*; D001786:Blood Glucose / Q000378:metabolism; D001798:Blood Proteins / Q000378:metabolism; D003131:Combined Modality Therapy; D005950:Glucose Solution, Hypertonic; D006801:Humans; D009104:Multiple Trauma / Q000097:blood / Q000628:therapy*; D009584:Nitrogen / Q000097:blood; D010289:Parenteral Nutrition, Total; D011379:Prognosis; D012774:Shock, Traumatic / Q000628:therapy
D000209:Acute-Phase Proteins; D000596:Amino Acids; D001786:Blood Glucose; D001798:Blood Proteins; D005950:Glucose Solution, Hypertonic; D009584:Nitrogen
Infusion von Aminosäurelösungen im Therapiekonzept des Trauma-Patienten. Vergleichende Untersuchungen in der Frühphase bei Polytrauma.