TY - JOUR
T1 - Arginine appearance and nitric oxide synthesis in critically ill infants can be increased with a protein-energy-enriched enteral formula
AU - de Betue, C.T.I.
AU - Joosten, K.F.
AU - Deutz, N.E.
AU - Vreugdenhil, A.C.
AU - van Waardenburg, D.A.
PY - 2013/1/1
Y1 - 2013/1/1
N2 - BACKGROUND: Arginine is considered an essential amino acid during critical illness in children, and supplementation of arginine has been proposed to improve arginine availability to facilitate nitric oxide (NO) synthesis. Protein-energy-enriched enteral formulas (PE-formulas) can improve nutrient intake and promote anabolism in critically ill infants. However, the effect of increased protein and energy intake on arginine metabolism is not known. OBJECTIVE: We investigated the effect of a PE-formula compared with that of a standard infant formula (S-formula) on arginine kinetics in critically ill infants. DESIGN: A 2-h stable-isotope tracer protocol was conducted in 2 groups of critically ill infants with respiratory failure because of viral bronchiolitis, who received either a PE-formula (n = 8) or S-formula (n = 10) in a randomized, blinded, controlled setting. Data were reported as means +/- SDs. RESULTS: The intake of a PE-formula in critically ill infants (aged 0.23 +/- 0.14 y) resulted in an increased arginine appearance (PE-formula: 248 +/- 114 mumol kg-1 h-1; S-formula: 130 +/- 53 mumol kg-1 h-1; P = 0.012) and NO synthesis (PE-formula: 1.92 +/- 0.99 mumol kg-1 h-1; S-formula: 0.84 +/- 0.36 mumol kg-1 h-1; P = 0.003), whereas citrulline production and plasma arginine concentrations were unaffected. CONCLUSION: In critically ill infants with respiratory failure because of viral bronchiolitis, the intake of a PE-formula increases arginine availability by increasing arginine appearance, which leads to increased NO synthesis, independent of plasma arginine concentrations. This trial was registered at www.trialregister.nl as NTR515.
AB - BACKGROUND: Arginine is considered an essential amino acid during critical illness in children, and supplementation of arginine has been proposed to improve arginine availability to facilitate nitric oxide (NO) synthesis. Protein-energy-enriched enteral formulas (PE-formulas) can improve nutrient intake and promote anabolism in critically ill infants. However, the effect of increased protein and energy intake on arginine metabolism is not known. OBJECTIVE: We investigated the effect of a PE-formula compared with that of a standard infant formula (S-formula) on arginine kinetics in critically ill infants. DESIGN: A 2-h stable-isotope tracer protocol was conducted in 2 groups of critically ill infants with respiratory failure because of viral bronchiolitis, who received either a PE-formula (n = 8) or S-formula (n = 10) in a randomized, blinded, controlled setting. Data were reported as means +/- SDs. RESULTS: The intake of a PE-formula in critically ill infants (aged 0.23 +/- 0.14 y) resulted in an increased arginine appearance (PE-formula: 248 +/- 114 mumol kg-1 h-1; S-formula: 130 +/- 53 mumol kg-1 h-1; P = 0.012) and NO synthesis (PE-formula: 1.92 +/- 0.99 mumol kg-1 h-1; S-formula: 0.84 +/- 0.36 mumol kg-1 h-1; P = 0.003), whereas citrulline production and plasma arginine concentrations were unaffected. CONCLUSION: In critically ill infants with respiratory failure because of viral bronchiolitis, the intake of a PE-formula increases arginine availability by increasing arginine appearance, which leads to increased NO synthesis, independent of plasma arginine concentrations. This trial was registered at www.trialregister.nl as NTR515.
U2 - 10.3945/ajcn.112.042523
DO - 10.3945/ajcn.112.042523
M3 - Article
SN - 0002-9165
VL - 98
SP - 907
EP - 916
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 4
ER -