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A Randomized Controlled Trial of the Influence of the Mode of Enteral Ornithine α-Ketoglutarate Administration in Burn Patients
- Source :
- The Journal of Nutrition. 128:563-569
- Publication Year :
- 1998
- Publisher :
- Elsevier BV, 1998.
-
Abstract
- To investigate appropriate mode and daily dose of enteral ornithine alpha-ketoglutarate (OKG) administration, 54 burn patients (total burn surface area: 20-50%) were included in a randomized controlled trial and assigned to receive either a supplement of OKG (10, 20 or 30 g/d) as bolus or continuous infusion, or a continuous infusion of an isonitrogenous amount of a soy protein mixture (Protil-1: 10, 20 or 30 g/d) in addition to their enteral diet. The influence of these treatments on clinical outcome and biological indices was evaluated. OKG administration significantly improved nitrogen balance and reduced 3-methylhistidine and hydroxyproline urinary elimination. This was associated with a gradual rise in plasma glutamine over time. Given as a bolus, OKG significantly improved wound healing, assessed both clinically [day of last graft: (mean +/- SEM) OKG bolus 23.7 +/- 2.1 d versus Protil-1, 39.9 +/- 9.9 d; P < 0.05] and by hydroxyproline excretion, and biological markers of nitrogen metabolism, and tended to reduce duration of enteral nutrition (P = 0.12). The higher catabolic status in the patients administered 20 g OKG/d at the onset of the study, despite randomization, precludes any definite conclusion (concerning the dose-effect relationship). However, based on 3-methylhistidine elimination, our data indicate a benefit of 30 g OKG/d administration over 10 g/d. This study further supports OKG supplementation in burn patients. In addition, this is the first trial based on objective data that favors bolus over continuous infusion of OKG in critically ill patients.
- Subjects :
- Adult
Male
Ornithine
medicine.medical_specialty
Randomization
Medicine (miscellaneous)
Enteral administration
Gastroenterology
law.invention
Excretion
chemistry.chemical_compound
Hydroxyproline
Enteral Nutrition
Bolus (medicine)
Randomized controlled trial
law
Internal medicine
medicine
Humans
Infusion Pumps
Nutrition and Dietetics
Dose-Response Relationship, Drug
business.industry
Middle Aged
Surgery
Treatment Outcome
Parenteral nutrition
chemistry
Soybean Proteins
Burns
business
Subjects
Details
- ISSN :
- 00223166
- Volume :
- 128
- Database :
- OpenAIRE
- Journal :
- The Journal of Nutrition
- Accession number :
- edsair.doi.dedup.....00e58dde07ccbb6dadf6fc846b1ebafe