Document Detail


Ornithine alpha-ketoglutarate improves wound healing in severe burn patients: a prospective randomized double-blind trial versus isonitrogenous controls.
MedLine Citation:
PMID:  10890617     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the effectiveness on wound healing time in severe burn patients of ornithine alpha-ketoglutarate supplementation of enteral feeding vs. an isonitrogenous control. Previous clinical and experimental studies suggest a beneficial effect of enterally administered ornithine alpha-ketoglutarate supplementation on protein metabolism in burn patients, but few data deal with clinical outcome. DESIGN: Prospective double-blind randomized trial. SETTING: Burn treatment center of an army hospital. PATIENTS: Forty-seven severe burn patients with total burned body surface areas of 25% to 95% and presence of full thickness burn who were prescribed early exclusive enteral nutrition. Either ornithine alpha-ketoglutarate or isonitrogenous control (soy protein mixture, Protil-1) were administered twice a day as a bolus (2 x 10 g) at 9 am and 9 pm for 3 wks. The patients were evaluated for wound healing time (primary end point), antibiotic use, tolerance, duration of enteral nutrition, and nutritional status. INTERVENTIONS: Serial blood samples were collected in each patient for determination of serum transthyretin and plasma phenylalanine, and urine sampling was performed for determination of 3-methylhistidine excretion at day 4 and day 21 after burn injury. MEASUREMENTS AND MAIN RESULTS: Wound healing times in patients receiving ornithine alpha-ketoglutarate or Protil-1 were 60 +/- 7 and 90 +/- 12 days, respectively (p < .05) for similar grafted surfaces. Based on increased serum transthyretin concentrations, both groups showed an improvement of nutritional status at day 21 after burn. Taking a cut-off value of 110 unit burn standard for severity of injury, plasma phenylalanine concentrations, and urinary 3-methylhistidine/creatinine ratio were significantly reduced (p < .05) in the less severe burn patients (<110 unit burn standard) supplemented with ornithine alpha-ketoglutarate. CONCLUSIONS: Ornithine alpha-ketoglutarate supplementation of enteral feeding significantly shortens wound healing time in severe burn patients. In addition, ornithine alpha-ketoglutarate administration was safe and well tolerated and decreased protein hypercatabolism in the less severe burn patients.
Authors:
C Coudray-Lucas; H Le Bever; L Cynober; J P De Bandt; H Carsin
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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:  Critical care medicine     Volume:  28     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-08-03     Completed Date:  2000-08-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1772-6     Citation Subset:  AIM; IM    
Affiliation:
Laboratoire de Biologie de la Nutrition, Faculté des Sciences de Pharmacie et de Biologie, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Burns / drug therapy*
Double-Blind Method
Enteral Nutrition*
Female
Humans
Injury Severity Score
Male
Ornithine / analogs & derivatives*,  therapeutic use
Prospective Studies
Soybean Proteins / therapeutic use*
Wound Healing / drug effects*
Chemical
Reg. No./Substance:
0/Soybean Proteins; 37339-58-5/ornithine alpha-ketoglutarate; 7006-33-9/Ornithine

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


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