• #8-1. Amino Acid IVNT Overview I


    Traditionally, the most widely used intravenous nutrition therapy (IVNT) is the amino acid therapy, due to its various benefits and actions. It can be used in replenishing the nutrition level in patients with malnutrition, those prone to fevers and colds, and as an ideal solution for adding other ingredients. Its biggest benefit is of course supplementation of proteins.

    Protein cannot be stored likecarbohydrates or fat and should be replenished every day to maintain health and life. Excess protein is not stored in the body and consumed to produce energy and one only needs to ingest the recommended daily intake. However, people with serious sickness, undergoing surgery, growth spurts and pregnant women need more protein than the normal amount. For example, a growing child needs to consume five times more protein than an adult does. A healthy adult needs to consume 800mg(0.8g) per 1kg body weight daily. Therefore, an adult weighing60kg needs to consume 48g of protein daily.


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    If sufficient energy cannot be produced due to carbohydrate or fat deficiency, protein is taken from tissues to produce energy. To prevent degradation of protein, it is important to have a balanced caloric intake. Nutritionists recommend a mean that consists of  15% protein, 20% fat, and 65% carbohydrates.

    Amino acid IVNT solutions have varying amino acid composition. Generally, a 500ml solution contains 30-50g of amino acid, which can be converted to 120-200kcal. However, as mentioned earlier, the purpose of amino acid IVNT is supplementation of protein rather than calories.

    It is important to consider the patient’s liver condition when administering amino acidIVNT. For example, a patient with liver cirrhosis has poor hepatic metabolism and amino acid IVNT can induce excreted nitrogen to cause hepatic encephalopathy. In such cases I recommend administering a branched chain amino acid(BCAA) solution. BCAA provides caloric energy without liver metabolism.


    Chemical structure of amino acid

    Amino acidis an organic compound that contains both the amino group(-NH₂) andcarboxyl group (-COOH) within a single molecule (Image 1). It is generally obtained from hydrolyzing protein. Amino acids form a typical dehydration linkage where to a water molecule from the carboxyl group of the front amino acid and that from the amino group of the back amino acid are lost to form various proteins. This is also called a peptide bond (-CO-NH-).


    Image 1. Structure of amino acid.


    -To be continued-

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