Perioperative amino acid infusion reestablishes muscle net balance during total hip arthroplasty.
Perioperative amino acid infusion reestablishes muscle net balance during total hip arthroplasty.
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DOI：
10.14814/phy2.15055
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发表时间：
2021-09
影响因子：
2.5
通讯作者：
Ferrando AA
中科院分区：
文献类型：
--
作者：
Church DD;Schutzler SE;Wolfe RR;Ferrando AA
手术和麻醉会诱导分解代谢反应，导致骨骼肌蛋白质丢失。以前的研究已经观察到围手术期营养的积极作用。此外，外源氨基酸对肌肉蛋白质动力学的益处已经很好地确立。然而，没有调查集中在肌肉蛋白动力学与围手术期氨基酸输注。因此，我们旨在评估围手术期氨基酸（AA）输注对择期全髋关节置换术（THA）患者肌肉蛋白平衡的影响。择期THA患者随机接受术前代谢研究（n = 5;对照[CON]）、术中AA输注（n = 9）或无AA（n = 13;标准治疗[SC]）。CON组在手术前进行研究，以提供非手术/非麻醉肌肉蛋白动力学参考值。使用推注法，在时间0注射13 C6-苯丙氨酸，30 min后注射[15 N]-苯丙氨酸，计算肌肉蛋白质合成（MPS）、蛋白质分解（MPB）和净平衡（MPS-MPB）。与SC相比，围手术期AA显著改善了肌肉净平衡（−0.005 ± 0.018%/h vs. −0.052 ± 0.011%/h），但CON（0.003 ± 0.013%/h）没有改善。AA输注通过显著增加MPS显著增加肌肉净平衡（AA = 0.062 ± 0.007%/h; SC = 0.037 ± 0.004%/h; CON = 0.072% ± 0.005%/h），MPB无显著衰减（AA = 0.067 ± 0.012%/h; SC = 0.089 ± 0.014%/h; CON = 0.075 ± 0.011%/h）。我们的数据支持在择期THA期间使用围手术期AA输注作为抵消手术诱导的骨骼肌蛋白丢失的实用策略。
Surgery and anesthesia induce a catabolic response that leads to skeletal muscle protein loss. Previous investigations have observed positive effects of perioperative nutrition. Furthermore, the benefits of exogenous amino acids on muscle protein kinetics are well established. However, no investigation has focused on muscle protein kinetics with and without perioperative amino acid infusion. Thus, we aimed to assess the effect of perioperative amino acid (AA) infusion on muscle protein balance in individuals undergoing elective total hip arthroplasty (THA). Elective THA patients were randomized to undergo a metabolic study prior to surgery (n = 5; control [CON]), intraoperative AA infusion (n = 9), or no AA (n = 13; standard of care [SC]). The CON group was studied prior to surgery to provide nonoperative/non‐anesthesia muscle protein kinetic reference values. The bolus infusion method with 13C6‐phenylalanine injected at time 0, and [15N]‐phenylalanine 30 min later was used to calculate muscle protein synthesis (MPS), protein breakdown (MPB), and net balance (MPS−MPB). Perioperative AA significantly improved muscle net balance as compared to SC (−0.005 ± 0.018%/h vs. −0.052 ± 0.011%/h) but not CON (0.003 ± 0.013%/h). The AA infusion significantly increased muscle net balance via a significant increase in MPS (AA = 0.062 ± 0.007%/h; SC = 0.037 ± 0.004%/h; CON = 0.072% ± 0.005%/h), and a nonsignificant attenuation of MPB (AA = 0.067 ± 0.012%/h; SC = 0.089 ± 0.014%/h; CON = 0.075 ± 0.011%/h). Our data support the use of perioperative AA infusion during elective THA as pragmatic strategy to offset the loss of surgically induced skeletal muscle protein.
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DOI：
10.1152/ajpendo.00576.2014
发表时间：
2015-04-15
影响因子：
5.1
作者：
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发表时间：
2000-02-01
影响因子：
5.1
作者：
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DOI：
10.1152/ajpendo.00166.2006
发表时间：
2007-01-01
影响因子：
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