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

Ann Surg. 2011 Mar;253(3):592-7. doi: 10.1097/SLA.0b013e31820d9a63.

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Amino Acids / administration & dosage*
  • Biopsy
  • Burns / physiopathology*
  • Burns / therapy*
  • Child
  • Child, Preschool
  • Electrolytes / administration & dosage*
  • Female
  • Glucose / administration & dosage*
  • Humans
  • Isotope Labeling
  • Male
  • Muscle Proteins / metabolism*
  • Muscle, Skeletal / pathology
  • Muscle, Skeletal / physiopathology*
  • Muscular Atrophy / physiopathology
  • Parenteral Nutrition Solutions*
  • Reference Values
  • Solutions / administration & dosage
  • Young Adult

Substances

  • Amino Acids
  • Electrolytes
  • Muscle Proteins
  • Parenteral Nutrition Solutions
  • Solutions
  • amino-acid, glucose, and electrolyte solution
  • Glucose