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Randomized Controlled Trial
. 2011 Mar;253(3):592-7.
doi: 10.1097/SLA.0b013e31820d9a63.

Skeletal muscle is anabolically unresponsive to an amino acid infusion in pediatric burn patients 6 months postinjury

Demidmaa Tuvdendorj  1 , David L Chinkes, Xiao-Jun Zhang, Melinda Sheffield-Moore, David N Herndon
Affiliations
Randomized Controlled Trial

Skeletal muscle is anabolically unresponsive to an amino acid infusion in pediatric burn patients 6 months postinjury

Demidmaa Tuvdendorj et al. Ann Surg. 2011 Mar.

Abstract

Objective: To evaluate leg muscle, whole-body muscle, and whole-body nonmuscle protein response to anabolic signaling of amino acids in pediatric burn patients at 6 months after injury.

Background: Burn injury is associated with a catabolic state persisting years after the injury. The tissue response to nutritional signaling (eg, amino acids) plays a critical role in tissue protein net balance via coordination of protein synthesis and breakdown mechanisms.

Methods: A total of 10 patients (7.4 ± 3.8 years; 27.4 ± 14.7 kg) and 5 healthy young males (22 ± 3 years; 76 ± 15 kg) underwent an 8-hour stable isotope infusion study. During the last 3 hours, an amino acid solution (10% Travasol, Clintec Nutrition, Deerfield, IL) was infused. Femoral arterial and venous blood samples and muscle biopsy samples were collected throughout the study. A P value of less than 0.05 was considered statistically different.

Results: During amino acid infusion, leg muscle protein synthesis rate significantly increased (P < 0.05) in both groups, however, in the burn group, protein breakdown also increased, although nonsignificantly. As a result, protein net balance remained negative. In the control group, breakdown nonsignificantly decreased resulting in a significant increase (P < 0.05) in muscle protein net balance. Whole-body protein breakdown was significantly higher in the burn patients.

Conclusion: In pediatric burn patients at 6 months postinjury, leg muscle protein net deposition is unresponsive to amino acid infusion; and whole-body protein breakdown is significantly higher than in the control group.

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Figures

FIGURE 1
FIGURE 1
Stable isotope infusion protocol.
FIGURE 2
FIGURE 2
Leg muscle protein kinetics. Data are presented as Means ± SE. A, Rate of disappearance (Rd); B, Rate of appearance (Ra); C, Net protein deposition (NB). *P < 0.05, significantly different from basal period; †P < 0.05, significantly different between the groups within the period.
FIGURE 3
FIGURE 3
Whole-body endogenous protein kinetics. Data are presented as Means ± SE. A, Whole-body protein rate of appearance; B, whole-body muscle protein rate of appearance; C, whole-body nonmuscle protein rate of appearance. *P < 0.05, significantly different from burn within the period; †P < 0.05, significantly different from the basal within the group; ‡, significantly different between groups within the period.
See this image and copyright information in PMC

References

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