[Effect of solutions with different amounts of branched-chain amino acids on the plasma amino acid pattern and energy metabolism of surgical intensive care patients].

30 intensive care surgical patients were investigated over a period of five days following trauma or major surgery. The patients were randomized into two groups. Both collectives received equal amounts of protein (1.0 g amino acids . kg-1 . d-1) and carbohydrate (6,7 g . kg-1 . d-1). Under this infusion regimen the patients of group I received an amino acid solution containing 45% branched-chain amino acids (BCCA), the patients of group II an amino acid solution with a 10% content of BCAAs. After only 24 hrs of infusion, the total amino acid concentration and branched-chain amino acid concentration in the plasma of patients receiving the solutions containing 45% BCAAs already clearly exceeded reference range, and continued increase during the entire investigation period. In those patients receiving the 10% branched-chain amino acid solution, these parameters rapidly returned to normal and then remained within reference range. Cumulative nitrogen balance and nitrogen balance on each day of investigation were significantly less negative in those patients administered the amino acid solution with small amounts of BCAAs. These results seem to indicate that after severe trauma or major surgery amino acid solutions containing high concentrations of BCAAs may be an unphysiological load on the already stressed metabolism, rather than a benefit