Document Detail


Influence of diet with or without amino acids on polyamine excretion in multiple trauma victims.
MedLine Citation:
PMID:  7934985     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Elevated levels of urinary polyamines (PA) in severely injured trauma patients are further enhanced by total parenteral nutrition (TPN) that contains both glucose and amino acids (AAs). Since TPN solutions contain arginine, the AA precursor of PA, it is not certain whether the increased urinary PA are due to this substrate. Nutritional factors can evidently modify PA metabolism. We measured the daily excretion of the PA, putrescine (PU) and spermidine (SD) in 18 multiply injured (injury severity score [ISS], 32 +/- 2), hypermetabolic (resting energy expenditure [REE]/basal energy expenditure [BEE], 1.41 +/- 0.06), and highly catabolic (daily N loss, 17.2 +/- 1.8 g N/d) acute trauma patients for 5 days in the early flow phase of injury. The patients were fed only maintenance fluids without calories or nitrogen for the first day 60 to 72 hours after injury, and then were randomized to receive glucose alone ([GLUC] 4.1 mg/kg/min, 80% measured REE, n = 8) or the same amount of glucose with AAs (TPN, 275 mg N/kg/d, n = 10) for the following 4 days. There was no significant difference in the enhanced daily PA excretion either in the free or acetylated form between the two dietary regimens. The addition of AAs in the TPN mixture did not seem to further stimulate PA metabolism in the trauma patients. The source of the nutrient content of the diet appears to be important for enhancing total PA excretion in critically ill patients.
Authors:
M Jeevanandam; M R Ali; S R Petersen
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Metabolism: clinical and experimental     Volume:  43     ISSN:  0026-0495     ISO Abbreviation:  Metab. Clin. Exp.     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-10-31     Completed Date:  1994-10-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375267     Medline TA:  Metabolism     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1305-9     Citation Subset:  IM    
Affiliation:
Trauma Center, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Amino Acids / administration & dosage*
Blood Urea Nitrogen
Energy Metabolism
Female
Glucose / administration & dosage*
Humans
Male
Middle Aged
Multiple Trauma / metabolism,  therapy*,  urine
Parenteral Nutrition, Total*
Polyamines / urine*
Putrescine / urine
Severity of Illness Index
Spermidine / urine
Chemical
Reg. No./Substance:
0/Amino Acids; 0/Polyamines; 110-60-1/Putrescine; 124-20-9/Spermidine; 50-99-7/Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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