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Effect of branched chain amino acid enriched amino acid solution on normalization of plasma amino acids in hepatic encephalopathy



Effect of branched chain amino acid enriched amino acid solution on normalization of plasma amino acids in hepatic encephalopathy



Taiwan yixuehui zazhi 84(3): 331-338



The therapeutic efficacy of 35% branched-chain amino acid (BCAA) treatment in 12 patients with post-operative hepatic encephalopathy was studied. The criteria used to select patients for BCAA-enriched amino acid treatment were hepatic dysfunction associated with various type of operation and levels of conscious disturbances. A mixture of 35% BCAA-enriched amino acid solution and 20-25% glucose was administerd by the central hyperalimentation technique. The mean day and BCAA dose administered were 15.6 .+-. 9.6 days and 58.9 .+-. 11.5 g/day, respectively. In this series, 8 of the 12 subjects maintained relatively alert in conscious levels despite step-raised levels of bilirubin. The plasma amino acid profile studied showed that the levels of BCAA, glutamine, alanine and lysine were low; the levels of phenylalanine, tyrosine, threonine, proline and glycine were high in hepatic encephalopathy. The ratio Leu+Ile+Val to Tyr+Phe changed from 3.2 in normal controls to 1.0 in the pre-BCAA-treated period and re-raised to 1.9 in the 7 day post-infusion period. A 35% BCAA-enriched amino acid solution, as given in this study, was able to normalize the deranged amino acid profile and was one of the important treatments for hepatic encephalopathy.

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Accession: 005223728

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PMID: 3860605


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