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The Effect of Amino Acid Infusions

Herbert R. Freund, MD; Michael Muggia-Sullam, MD; Richard LaFrance, PharmD; Jane Holroyde; Josef E. Fischer, MD

Arch Surg. 1986;121(2):209-216.

Abstract
• Regional amino acids and brain neurotransmitters were studied in 33 normal and 32 rats with sepsis (induced by cecal ligation and puncture) infused with different amino acid formulations. The brain amino acid pattern during sepsis showed increased concentrations of most essential and six of the nonessential amino acids. The most consistent finding was the accumulation of indoleamines in all six brain regions studied during sepsis; increased brain tryptophan levels presumably resulted in enhanced metabolism of serotonin (5HT), increased production of 5-hydroxyindoleacetic acid (5HIAA), and a high 5HT/5HIAA ratio. Infusion of branched-chain amino acid—enriched formulas restored brain amino acid and neurotransmitter profiles, decreasing levels of tryptophan, tyrosine, 5HIAA, and 5HT/5HIAA ratios while increasing norepinephrine levels in some regions. These alterations in brain neurotransmitter metabolism may be at least partially responsible for the development of septic encephalopathy.

(Arch Surg 1986;121:209-216)

Author Affiliations
From the Department of Surgery, University of Cincinnati Medical Center. Drs Freund and Muggia-Sullam are now with the Department of Surgery B, Hebrew University, Hadassah Medical School, Jerusalem.

Footnotes
Accepted for publication July 25, 1985.

Reprint requests to Department of Surgery, University of Cincinnati Medical Center, 231 Bethesda Ave, Cincinnati, OH 45267-0558 (Dr Fischer).

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