Differences in the Serum Amino Acid Pattern of Injured and Infected Children Promoted by Two Parenteral Nutrition Solutions

The effects of two parenteral nutrition (PN) amino acid solutions (FreAmine II and F080) on the serum amino acid levels of 51 children, 27 affected by multiple trauma and 24 by bacterial sepsis, and aged from 1 month to 12 years, were studied. Serum amino acids were determined on day 1 immediately before administrating PN, and on day 5 during PN. Trauma patients on F080 exhibited higher levels of alanine, aspartate, asparagine, leucine, isoleucine, valine, total branched-chain amino acids (BCAA) and total essential amino acids than those on FreAmine II; in contrast septic children showed similar levels of serum amino acids on both PN solutions. BCAA were lower in septics than in trauma patients, probably as a consequence of an increased utilization of these amino acids in sepsis because of the higher organ protein synthesis typical of this situation. The phenylalanine/tyrosine ratio was found elevated both in septic and trauma children, but it decreased after PN in the latter when using an enriched BCAA solution. Utilization of this solution, partly corrects the metabolic disturbances induced by stress, but the metabolical responses induced either by sepsis or trauma are partially different which may have important implications for patient care. (Journal of Parenteral and Enteral Nutrition 13:41-46, 1989)