title: Lower plasma arginine in enteral tube-fed patients with pressure ulcer and improved pressure ulcer healing after arginine supplementation by Arginaid Water.
abstract: OBJECTIVE
  To determine the presence or extent of arginine deficiency in pressure ulcer (PU) patients on percutaneous endoscopic gastrostomy (PEG) feeding and to examine the effects of arginine supplementation on PU healing.
  
  
  METHODS
  All eligible PEG patients, with and without PU, were cross-sectionally assessed for plasma arginine. Three-month supplementation with arginine-enriched water (Arginaid Water) was performed on a subset of patients with PU. This intervention study was a prospective, non-controlled trial with 5 PU patients.
  
  
  METHODS
  Geriatric ward of a rural clinical hospital in Japan.
  
  
  METHODS
  Thirty-nine inpatients with PEG feeding were assessed for plasma arginine. Five of the 13 patients with PU and five of 26 patients without PU underwent amino acid profiling.
  
  
  METHODS
  Five of the patients with PU received Arginaid Water supplementation.
  
  
  METHODS
  Plasma amino acid measurements and biochemical analyses were performed. For those with PU on Arginaid Water supplementation, plasma arginine concentration and PU status were monitored every month.
  
  
  RESULTS
  Patients with PU showed significantly lower plasma arginine concentration compared to those without PU (control vs. PU; 80.2±21.3 vs 62.8±14.7 nmol/ml, p<0.01). After the addition of Arginaid Water, plasma arginine concentration increased (before vs 3 months later; 57.9±1.8 vs 83.1±8.5, p<0.01), and PU area, perimeter, DESIGN-R and PUSH scores significantly improved.
  
  
  CONCLUSIONS
  Plasma arginine was lower in PEG patients with PU. The healing rate of PU is improved with Arginaid Water supplementation. The findings from this study support the use of arginine supplementation in PEG patients with PU.
authors: Division of Health Science Research, Fukushima Welfare Federation of Agricultural Cooperatives, Fukushima, Japan. jyatabe@fmu.ac.jp
authors: J
authors: J
authors: Yatabe
authors: F
authors: F
authors: Saito
authors: I
authors: I
authors: Ishida
authors: A
authors: A
authors: Sato
authors: M
authors: M
authors: Hoshi
authors: K
authors: K
authors: Suzuki
authors: T
authors: T
authors: Kameda
authors: S
authors: S
authors: Ueno
authors: M S
authors: MS
authors: Yatabe
authors: T
authors: T
authors: Watanabe
authors: H
authors: H
authors: Sanada
mesh_terms: D000369:Aged, 80 and over; D000704:Analysis of Variance; D001120:Arginine / Q000097:blood* / Q000172:deficiency / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D003668:Pressure Ulcer / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D011446:Prospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: D001120:Arginine