Plasma Amino Acid Concentrations during Branched-chain Amino Acid Infusions In Stressed Patients

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Abstract
To determine the effect of infusing large quantities of BCAA on plasma amino acid concentrations, plasma amino acid profiles were measured in 18 stressed patients before and 48-96 h after initiation of amino acid solutions enriched with or exclusively containing BCAA (15.6, 50, 100%). Plasma concentrations of BCAA were evaluated in the 100% and 50% BCAA groups, but not in the 15.6% group. Methionine, glycine and phenylalanine concentrations were increased in the 15.6% BCAA group; methionine and glycine were decreased in the 100% BCAA group. In the 50% BCAA group, nonbranched-chain amino acids maintained baseline concentrations. The 50% solution best preserved N balance of the BCAA solutions. The plasma amino acid profiles of patients with maple syrup urine disease (BCAA levels 5-10 times normal) were compared to these patients receiving BCAA-enriched solutions. Although plasma BCAA levels were elevated in these patients, allo-isoleucine, alanine and glutamine concentrations were normal; the amino acid abnormalities of maple syrup urine disease were not observed.