A branched chain amino acid-enriched solution does not induce any beneficial effect on the postoperative intestinal functions.
OBJECTIVE
This study was conducted in order to clarify the significance of using a branched chain amino acid-enriched solution on surgical patients, especially regarding the postoperative nitrogen balance as well as such intestinal functions as permeability and immunity.


METHODS
Eight patients were prospectively and randomly divided into 2 groups. Consisting of a control group (n = 4) who all received conventional postoperative hyperalimentation using the branched chain amino acid-enriched solution; and a high-dose group (n = 4), who received an additional amount of branched chain amino acid-enriched solution immediately after operation up until postoperative day 7. No significant differences were observed in the background variables between the two groups.


RESULTS
The nitrogen balance in the high dose group from postoperative day 1 to day 4 was significantly better for all compared to those of the control group. The ratio of the branched-chain amino acids to aromatic amino acids at postoperative day 3 in the high dose group was significantly higher than that in the control group. The urinary 3-methylhistidine excretion in the high-dose group tended to be lower than that in the control group. However, regarding the intestinal functions, no significant differences between the two groups were observed regarding the lactulose-mannitol test, the rate of positive Candida antigen, and the serum level of secretary immunoglobulin A, or the serum activity of diamine oxidase.


CONCLUSIONS
A high dose branched chain amino acid-enriched solution can improve immediately postoperative nitrogen balance and may also lead to the prevention of a breakdown in the skeletal muscles. However, no beneficial effects were observed in the postoperative intestinal functions, which play an important role in preventing bacterial translocation.
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
M
M
Shimada
H
H
Hasegawa
T
T
Gion
K
K
Shirabe
K
K
Takenaka
T
T
Kano
K
K
Sugimachi
D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000032:analysis / Q000627:therapeutic use*; D018988:Bacterial Translocation / Q000187:drug effects; D005260:Female; D006801:Humans; D007422:Intestines / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008762:Methylhistidines / Q000652:urine; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies
D000597:Amino Acids, Branched-Chain; D008762:Methylhistidines; C028118:3-methylhistidine; D009584:Nitrogen