Metabolic and clinical effects of the supplementation of a functional mixture of amino acids in cerebral hemorrhage.
BACKGROUND
Oral supplementation of a specific mixture of essential and non-essential amino acids has been shown to modulate hypercatabolism in patients with chronic heart failure, leading to improved clinical outcome. The aim of this study was to test whether such effects could be replicated in an acute clinical model of hypercatabolism.


METHODS
After approval by the Ethics Committee, patients with acute brain hemorrhage admitted to the Neurosurgical ICU were randomly assigned to receive enterally for 14 days 20% of their estimated nitrogen requirements as a standard protein supplement (control group; n = 9) or as a functional amino acid mixture (Aminotrofic®, Errekappa Euroterapici; study group; n = 10). Metabolic and clinical outcome measures were monitored.


RESULTS
In the study group, insulin sensitivity and total lymphocyte count appeared to improve when compared with control patients. Less positive blood cultures were found in the study group against control patients (4 vs. 7, respectively; P = 0.05). Also, mortality in the study group was reduced than in control patients (60 vs. 77%; P = n.s.).


CONCLUSIONS
Supplementation with specific amino acids in critically ill patients may modulate metabolic response and improve clinical outcome.
Department of Clinical Medicine, Sapienza University, Rome, Italy. alessandro.laviano@uniroma1.it
Alessandro
A
Laviano
Flavia
F
Aghilone
Donato
D
Colagiovanni
Federica
F
Fiandra
Roberta
R
Giambarresi
Paolo
P
Tordiglione
Alessio
A
Molfino
Maurizio
M
Muscaritoli
Giovanni
G
Rosa
Filippo
F
Rossi Fanelli
D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000596:Amino Acids / Q000008:administration & dosage*; D001921:Brain / Q000187:drug effects* / Q000378:metabolism; D002543:Cerebral Hemorrhage / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D003422:Critical Care / Q000379:methods*; D004734:Energy Metabolism / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D016896:Treatment Outcome; D055815:Young Adult
D000596:Amino Acids