October 1988

Nitrogen Balance in Adult Hospitalized Patients With the Use of a Pediatric Amino Acid Model

Author Affiliations

From the Department of Surgery, University of California, Irvine (Drs Gazzaniga and Waxman and Ms Day); Medical Department, Kendall McGaw, Irvine, Calif (Mr Bradford); Departments of Pediatrics and Surgery, University of Nebraska, Omaha (Dr Vanderhoof); Division of Trauma Surgery, Henry Ford Hospital, Detroit (Dr Bivins); and the Department of Surgery, Cleveland Clinics (Dr Steiger).

Arch Surg. 1988;123(10):1275-1279. doi:10.1001/archsurg.1988.01400340101018

• Normalization of plasma amino acid patterns and that relationship to improved nitrogen balance was studied using a pediatric-specific amino acid solution in 21 adults requiring total parenteral nutrition therapy. There was a significantly positive correlation between improved nitrogen balance and the amino acids cystine, tyrosine, total cysteine/cystine, and ornithine. When additional cysteine was added to the solution of 11 subjects, taurine also correlated with nitrogen balance. Despite higher amounts of histidine in solution, plasma amino acid levels were not normalized. These amino acids, heretofore considered nonessential, may be required in specific molar ratios in stress. The use of a 30% branched-chain pediatric-balanced amino acid solution resulted in near normalization of plasma amino acid levels and group mean positive nitrogen balance.

(Arch Surg 1988;123:1275-1279)