科研之友
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摘要
Background: Arginine is considered an essential amino acid during critical illness in children, and supplementation of arginine has been proposed to improve arginine availability to facilitate nitric oxide (NO) synthesis. Protein-energy-enriched enteral formulas (PE-formulas) can improve nutrient intake and promote anabolism in critically ill infants. However, the effect of increased protein and energy intake on arginine metabolism is not known. %26lt;br%26gt;Objective: We investigated the effect of a PE-formula compared with that of a standard infant formula (S-formula) on arginine kinetics in critically ill infants. %26lt;br%26gt;Design: A 2-h stable-isotope tracer protocol was conducted in 2 groups of critically ill infants with respiratory failure because of viral bronchiolitis, who received either a PE-formula (n = 8) or S-formula (n = 10) in a randomized, blinded, controlled setting. Data were reported as means +/- SDs. %26lt;br%26gt;Results: The intake of a PE-formula in critically ill infants (aged 0.23 +/- 0.14 y) resulted in an increased arginine appearance (PE-formula: 248 6 114 mu mol . kg(-1) . h(-1); S-formula: 130 +/- 53 mu mol . kg(-1) . h(-1); P = 0.012) and NO synthesis (PE-formula: 1.92 +/- 0.99 mu mol . kg(-1) . h(-1); S-formula: 0.84 +/- 0.36 mu mol . kg(-1) . h(-1); P = 0.003), whereas citrulline production and plasma arginine concentrations were unaffected. %26lt;br%26gt;Conclusion: In critically ill infants with respiratory failure because of viral bronchiolitis, the intake of a PE-formula increases arginine availability by increasing arginine appearance, which leads to increased NO synthesis, independent of plasma arginine concentrations. This trial was registered at www.trialregister.nl as NTR515.
- 出版日期2013-10
