Effect of Nutriflex 48 on the plasma amino acid pattern in surgical intensive care patients with infection

: Nutriflex 48 (48 g amino acids and 1250 nonprotein kcal/l), containing 20% branched chain amino acids, was infused in a dose of 2000 ml per day over a period of 14 days to 8 surgical intensive care patients with sepsis and concomitant liver dysfunction. Cumulative nitrogen balance was negative on each day of investigation, as aspected in those patients. The amino acid patterns in plasma showed increased concentrations of methionin, while the concentration of branched chain amino acids remained in the normal range until the end of the study. The concentration of plasma ammonium was always normal. These results seem to indicate that in septic patients a total parenteral nutrition with conventional amino acid solutions containing normal concentrations of branched chain amino acids, is possible. The results of the present study show that the necessity of parenteral nutrition in septic patients with highly branched chain amino acids can not be supported.