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Randomized Controlled Trial
. 2025 Jun 19;25(1):439.
doi: 10.1186/s12876-025-03696-3.

Prospective randomized, placebo-controlled study: role of branched-chain amino acids infusion as adjunct therapy post-liver surgery for patients in the intensive care unit

Eman Ibrahim El-Desoki Mahmoud  1 , Faten Farid Awdallah  2
Affiliations
Randomized Controlled Trial

Prospective randomized, placebo-controlled study: role of branched-chain amino acids infusion as adjunct therapy post-liver surgery for patients in the intensive care unit

Eman Ibrahim El-Desoki Mahmoud et al. BMC Gastroenterol. .

Abstract

Background and aim: Several animal studies have shown that Branched-chain amino acids (BCAAs) may prevent acute liver injury, although its effects in humans are as yet undetermined. Thus the purpose of this study is to evaluate the impact of intravenous BCAAs infusion on liver profile post-liver surgery in the intensive care unit (ICU).

Methods: A randomized study that was applied for post liver surgery patients who were randomly allocated to receive either intravenous BCAA immediately post-operative or placebo.

Measurements: Follow-up liver profile, Child-Pugh, and SOFA scores during the first week post-surgery.

Main results: A significant decline of bilirubin and ALT on day three and five in the BCAA group compared to the control group respectively. There was a significant improvement of PT on day seven 12.5 in the BCAA group versus 12.9 in the control group, p-value 0.01. Total bilirubin levels decreased by 75% in the BCAA group, whereas in the control group saw an increase of 6.25% from the baseline which was statistically significant, p-value 0.0376. SOFA score was markedly improved in the BCAA group (p-value 0.013). In addition to a significantly shorter ICU stay in the BCAA group than in the control group (p-value 0.018).

Conclusion: There are beneficial effects of BCAAs infusion post-liver surgery; including improved metabolic profile (liver function tests), and shorter ICU stay.

Trial registration: (Clinicaltrials.gov registration number:NCT03448848), 28/02/2018.

Keywords: Branched chain amino acid infusion; Critically ill; Hepatic patients; Liver surgery.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The protocol was approved by the institutional review board of the national hepatology and tropical medicine research institute (NHTMRI), Cairo, Egypt. All study procedures were performed in accordance with good clinical practice and the declaration of Helsinki. Written informed consent was obtained from each patient or a legally authorized representative prior to enrollment in the study. The patients' information is kept confidential and not to be viewed except by those who are conducting the research. All patients have the right to refuse to continue the study at any time or not to be included from the start. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
CONSORT flow diagram showing the flow of patients throughout the study
Fig. 2
Fig. 2
Diagrams A, B & C showing the median range of ALT, bilirubin & PT over the study period
See this image and copyright information in PMC

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