Nitrogen balance, 3-methylhistidine excretion, and plasma amino acid profile in infants after cardiac operations for congenital heart defects: the effect of early nutritional support

The Journal of Thoracic and Cardiovascular Surgery
V ChaloupeckýL Sprongl

Abstract

The objective of this study was to evaluate the effect of nutritional support on proteolysis and plasma amino acid profile in infants early after cardiac operations for congenital heart defects. Thirty-seven patients, 2 to 12 months old, were randomized on postoperative day 1 for 24-hour isocaloric metabolic study. Group STANDARD (18 patients) received glucose as the maintenance fluid, and group PN (19 patients) received glucose and crystalloid amino acid solution at a dosage of 0.8 +/- 0.1 gm/kg per day. The nonprotein caloric intake in the two groups was 25 +/- 15 and 33 +/- 9 kcal/kg, respectively (p = not significant). The nitrogen balance was markedly less negative in group PN than in group STANDARD (-114 +/- 81 vs -244 +/- 86 mg/kg, respectively, p = 0.001). There was a highly significant inverse correlation between the nitrogen balance and urinary 3-methylhistidine excretion in both groups, but the muscle proteolysis was blunted more effectively in patients receiving amino acids. Concentrations of the plasmatic branched-chain amino acids, alanine, glycine, and proline, decreased significantly in group STANDARD but not in group PN on postoperative day 2. Glutamine and threonine levels declined significantly on postoperati...Continue Reading

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Citations

Mar 16, 2016·The New England Journal of Medicine·Tom FivezGreet Van den Berghe
Sep 15, 2014·Archives of Physical Medicine and Rehabilitation·Kotaro IwatsuAkihiko Usui
Apr 23, 2013·Congenital Heart Disease·Benjamin J TooleJorge A Coss-Bu
Apr 8, 2017·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Jorge A Coss-BuRyan T Hurt
Apr 9, 2015·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jeremy G FisherTom Jaksic
Mar 20, 2019·Journal of Pediatric Gastroenterology and Nutrition·Javed IsmailSavita V Attri
Jul 12, 2017·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Nilesh M MehtaCarol Braunschweig
Jul 15, 2015·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Vijay Srinivasan
Mar 28, 2002·Journal of Inherited Metabolic Disease·U LangenbeckV Hönig

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