Qualitative manipulation of amino acid supply during total parenteral nutrition in surgical patients

We investigated whether a qualitative manipulation of amino acid mixture could improve the nutritional status of patients undergoing surgery. Patients received total parenteral nutrition for 2 consecutive 5-day periods. Energy and nitrogen supplies were calculated using a modified Harris-Benedict equation, with an energy-to-nitrogen ratio of 125 kcal/g nitrogen (N). The mean kilocalorie lipids-to-glucose ratio was 35% to 65%. There were 6 patients in the control group and 7 patients in the experimental group. The control group received the same standard amino acid solution (Vintene, Baxter-Clintec, Maurepas, France) for the entire 10 days. The experimental group received the standard solution during the first 5 days but was switched to a more individualized solution during the last 5 days. The second solution was determined from a linear regression performed on day 3 comparing rate of infusion of each amino acid and its plasma variations after 3 hours of infusion with basal values. Amino acids were define...