title: Amino acid composition in parenteral nutrition: what is the evidence?
abstract: OBJECTIVE
  Complete parenteral nutrition solutions contain mixed amino acid products providing all nine essential amino acids and a varying composition of nonessential amino acids. Relatively little rigorous comparative efficacy research on altered parenteral nutrition amino acid composition has been published in recent years.
  
  
  RESULTS
  Limited data from randomized, double-blind, adequately powered clinical trials to define optimal doses of total or individual amino acids in parenteral nutrition are available. An exception is the growing number of studies on the efficacy of glutamine supplementation of parenteral nutrition or given as a single parenteral agent. Parenteral glutamine appears to confer benefit in selected patients; however, additional data to define optimal glutamine dosing and the patient subgroups who may most benefit from this amino acid are needed. Although some promising studies have been published, little data are available in the current era of nutrition support on the clinical efficacy of altered doses of arginine, branched chain amino acids, cysteine, or taurine supplementation of parenteral nutrition.
  
  
  CONCLUSIONS
  Despite routine use of parenteral nutrition, surprisingly little clinical efficacy data are available to guide total or specific amino acid dosing in adult and pediatric patients requiring this therapy. This warrants increased attention by the research community and funding agencies to better define optimal amino acid administration strategies in patient subgroups requiring parenteral nutrition.
authors.affiliation: Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: Shadi S
authors.initials: SS
authors.lastname: Yarandi
authors.forename: Vivian M
authors.initials: VM
authors.lastname: Zhao
authors.forename: Gautam
authors.initials: G
authors.lastname: Hebbar
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Ziegler
mesh_terms: D000596:Amino Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D005973:Glutamine / Q000627:therapeutic use; D006801:Humans; D057947:Parenteral Nutrition Solutions / Q000737:chemistry*; D010289:Parenteral Nutrition, Total; D016896:Treatment Outcome
chemical_list: D000596:Amino Acids; D057947:Parenteral Nutrition Solutions; D005973:Glutamine