The Absence of Protein -sparing Effects Utilizing Crystalline Amino Acids in Stressed Patients

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Abstract
The protein-sparing effects of the peripheral infusion of crystalline amino acids (PAA) were studied metabolically in selected surgical patients subjected to various degrees of stress. Patients (16 cancer patients receiving chemotherapy and/or radiotherapy, 3 with major abdominal traumatic injuries and 4 with paralytic ileus) were infused with 2 1/24 h of a solution of 4.2% Travasol amino acids with 5% glucose as a source of nonprotein calories. Of the cancer patients, 1/2 were allowed ad lib oral intake of a regular hospital diet or Vivonex-HN. The nutritional status was evaluated by measuring changes in body weight, serum albumin levels and N balance. Body weight decreased in only the trauma patients. When these solutions were the sole source of nutrients all patients were in negative N balance and had significant decreases in their serum albumin levels. Serum albumin levels were preserved only when extra sources of calories were provided. The infusion of the crystalline amino acids without adequate levels of nonprotein energy did not conserve protein in these stressed patients.