July 1987

Metabolic and Immune Effects of Dietary Arginine Supplementation After Burn

Author Affiliations

From the Shriners Burn Institute, Cincinnati (Drs Saito, Wang, and Alexander and Ms Trocki) and the Department of Surgery, University of Cincinnati Medical Center (Ms Gonce and Dr Joffe). Dr Saito is now with the Department of Surgery, University of Tokyo. Dr Wang is now with the Burn Center, Southwestern Hospital, Chongqing, People's Republic of China.

Arch Surg. 1987;122(7):784-789. doi:10.1001/archsurg.1987.01400190050010

• The effect of supplemental dietary arginine on metabolism and immunity was studied in 36 burned guinea pigs (30% of total body surface area) with previously placed catheter gastrostomies. The animals were randomized into four groups. After an initial three-day adaptation period, all groups received continuous isonitrogenous, isocaloric (175 kcal [735 kJ]/kg/d), and isovolemic intragastric tube feedings until postburn day (PBD) 14. Groups A, B, C, and D received 0%, 1%, 2%, and 4%, respectively, of total energy intake as arginine given in the form of crystalline arginine hydrochloride with 22%, 21%, 20%, and 18%, respectively, of total energy as whey protein. The average body weight after burn decreased equally in all groups. Resting metabolic expenditure on PBD 6 was higher in groups B (151%±6% of preburn) and C (156%±7%) than in groups A (131%±4%) and D (136%±3%). Ear-thickness response to dinitrofluorobenzene challenge on PBD 12 showed the best response in group C. The mortality rates of groups A, B, C, and D were 56%, 29%, 22%, and 56%, respectively. This study suggests that oral dietary arginine supplementation up to 2% of energy intake may be beneficial after burn injury.

(Arch Surg 1987;122:784-789)