The objective of this study was to investigate the potential benefit of branched chain amino acid (BCAA)-enriched total parenteral nutrition (TPN) for malnourished surgical patients with gastrointestinal cancer. Sixty-four malnourished patients with gastrointestinal cancer with elective
surgical intervention were equally allocated into two groups to receive isonitrogenous and iso-caloric TPN. All of them must have received TPN soon after surgery and were subsequently randomized and divided into either BCAA-enriched TPN (30% BCAA; intervention group) or standard TPN (24% BCAA;
control group). Patient biochemical data, nutritional parameters, and clinical outcome were collected to analyze the significance of BCAA-enriched TPN. After a period of TPN, laboratory data, including white blood cell (WBC), C-reactive protein (CRP), alkaline phosphatase (ALK-P), and gamma-glutamyltransferase
(γ-GT) levels, were significantly different between these two groups (all P < 0.05). Decreasing white blood cell and C-reactive protein levels were observed in the intervention group that might partially explain the reduced numbers of infectious complications. Furthermore,
elevating alkaline phosphatase and gamma-glutamyl-transferase levels being also less prominent might indicate a lesser hepatic burden by using BCAA-enriched TPN. The BCAA-enriched TPN can maintain a patient's serum visceral protein (albumin and prealbumin) and positive nitrogen balance better
than standard TPN (all P < 0.05). Furthermore, a prominently decreased frequency of postoperative morbidity was also found in the BCAA-enriched TPN group (P = 0.021) despite no difference regarding surgical mortality. Our observations show that BCAA-enriched TPN may
be beneficial in improving the nutritional status and reducing postoperative complications for malnourished patients with gastrointestinal cancer undergoing major surgery.
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Document Type: Research Article
From theNutrition Support Team and the Departments of, Nursing
From theNutrition Support Team and the Departments of, Internal Medicine
From theNutrition Support Team and the Departments of, Surgery, and, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
From theNutrition Support Team and the Departments of, Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; and the
From theNutrition Support Team and the Departments of, Surgery, and
Publication date: March 1, 2008
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