Outcomes after Postoperative Amino Acid Supplementation
in Patients Undergoing Elective Upper and Lower
Gastrointestinal Tract Surgery: Randomized Controlled Trial
Chalerm Eurboonyanun MD1, Anan Sripanaskul MD1, Somchai Ruangwannasak MD1,
Ekkaphong Sathitkarnmanee MD1, Tharathip Srisuk MD1, Potchavit Aphinives MD1, Sumalee Posri BSc2
Affiliation :
1 Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
2 Parenteral Nutritional Therapy Unit, Nursing Service, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background : Surgical patients in a catabolic phase will affect vital functions such as the respiratory mechanism. Peripheral
parenteral nutrition with amino acids can reduce fat and protein breakdown and preserve the protein sparing effect resulting
in better outcomes. Due to (cid:976)inancial limitations, most Thai surgical patients receive only peripheral venous feeding with glucose
alone, without amino acids.
Objective : To investigate the postoperative nitrogen balance among Thai surgical patients receiving elective gastrointestinal surgery
with different peripheral intravenous feeding.
Materials and Methods : Thirty-six post-elective gastrointestinal surgery patients were enrolled in an open labeled, prospective,
randomized controlled trial. Patients received 3% amino acid with 7.5% dextrose (n = 12), 5% dextrose (n = 12), or 10% dextrose
(n = 12). From the (cid:976)irst postoperative day, the peripheral venous solutions were infused into the three groups for 72 hours. The
nitrogen balance was assessed by collecting 24 hours urine on the (cid:976)irst and third post-operative day. Markers for protein metabolism
were investigated (viz., pre-albumin, transferrin, and blood urea nitrogen).
Results : The nitrogen balance on the (cid:976)irst and third post-operative day were observed in all groups. There was signi(cid:976)icantly
improvement after 3% amino acid plus 7.5% dextrose infusion (-1.37, -2.47), compared with either 10% dextrose (-8.53, -7.04),
or 5% dextrose (-8.76, -7.90) infusion. Length of stay, serum transferrin, and serum pre-albumin made no signi(cid:976)icant difference
among the three groups.
Conclusion : Three percent amino acids plus 7.5% dextrose reduced post-operative negative nitrogen balance in gastrointestinal
tract surgical patients without any serious complications.
Keywords : Randomized controlled trial, RCT, Amino acid, Peripheral parenteral nutrition
All Articles
Download