Amino acid supplements in critically ill patients.

Autor: Gunst J; Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: jan.gunst@kuleuven.be., Vanhorebeek I; Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: ilse.vanhorebeek@kuleuven.be., Thiessen SE; Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: steven.thiessen@uzleuven.be., Van den Berghe G; Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: greet.vandenberghe@kuleuven.be.
Jazyk: angličtina
Zdroj: Pharmacological research [Pharmacol Res] 2018 Apr; Vol. 130, pp. 127-131. Date of Electronic Publication: 2017 Dec 06.
DOI: 10.1016/j.phrs.2017.12.007
Abstrakt: Observational studies have associated a low amino acid intake with adverse outcome of critical illness. Although this finding could theoretically be explained by differences in feeding tolerance related to illness severity, guidelines have recommended to administer sufficient amounts of amino acids from early onwards in the disease course. Recently, however, several high quality randomized controlled trials have not shown benefit by early amino acid supplementation and some trials even found potential harm, thus questioning this recommendation. These negative results could be related to amino acid-induced suppression of autophagy, to the inability to suppress bulk catabolism by exogenous amino acids, or to the administration of an amino acid mixture with an inappropriate composition. Currently, there is no evidence supporting administration of individual amino acid supplements during critical illness and glutamine administration may be harmful. The optimal timing, dose and composition of the amino acid mixture for critically ill patients remain unclear.
(Copyright © 2017 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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