Branched chain amino/keto acid supplementation following severe burn injury: a preliminary report.

Abstract 14 severely burned patients were randomly assigned to receive one of three nasogastric feeds commencing after the resuscitation period and continuing for 15 days. Group A received a feed with a high leucine content (31% of protein as branched chain amino-acids, BCAA). Group B received a similar feed to Group A but 65% of the leucine was replaced by alpha-ketoisocaproate (KIC). Group C received a whole protein feed (16% of the protein content as BCAA), and acted as a control group. Targeted energy intake was twice the calculated Basal Metabolic Rate (BMR). Group A had significantly reduced urinary 3-methylhistidine (3-MEH) and serum urea, compared with the control group. Serum total protein, albumin and transferrin and apparent nitrogen balance were not significantly different. Group B's results did not vary significantly from controls. Leucine enrichment reduces muscle protein breakdown benefiting burn patients fed enterally when compared to a standard feed, whereas KIC enrichment does not.