Traditionally, the most well-known intravenous nutrition therapy (IVNT) is amino acid IVNT. Amino acids serve various purposes; nutrition supplementation in patients with malnutrition, alleviating symptoms in patients with a cold or fever, and a basic solution where other nutrients can be combined. The biggest benefit of amino acids is protein supplementation.

 

Unlike carbohydrates or fats, proteins cannot be stored in our body and humans need to replenish large amounts of protein each day to maintain life and health. As excess protein is not stored and consumed as energy, it is not necessary to take more protein than the recommended amount. However, patients with chronic illness, or undergoing surgery, growing children, and pregnant women need a bigger protein intake compared to a normal person. It is said that the human body requires five times more protein during childhood than in the adulthood. A normal adult requires about 800mg (0.8g) of protein per 1Kg of bodyweight each day. Therefore, an adult weighing 60kg needs to consume 48g of protein daily.

 

Image 1. Amino acid structure.

 

When there is insufficient amount of carbohydrates or fats for energy production, proteins, the body’s building blocks, are degraded to generate energy. Therefore, to prevent protein degradation, it is important to have a balanced caloric intake. Nutritionists recommend the following ratio of daily caloric intake: 15% protein, 20% fat, and 65% carbohydrates 65%.

 

Amino acid solutions differ slightly in composition depending on the product. In general, a 500ml solution contains 30-50g of amino acid, which is about 120-200kcal in calories. However, as mentioned above, the purpose of amino acid IVNT is protein supplementation rather than caloric intake.

 

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One thing the doctor needs to pay attention to before administering amino acid IVNT is to check the patient’s liver condition. This is very important as patients with poor liver function such as liver cirrhosis, have poor liver metabolism which can lead to hepatic encephalopathy by nitrogen waste traveling to the brain. I recommend using solutions only containing branched chain amino acid (BCAA) in such cases. BCAA provides nutrition without going through liver metabolism.

 

-To be continued