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Metabolic and Immune Effects of Dietary Arginine Supplementation After Burn

Hideaki Saito, MD; Orrawin Trocki, RD, MS; Shi-liang Wang, MD; Sara J. Gonce; Stephen N. Joffe, MD; J. Wesley Alexander, MD, ScD
Arch Surg. 1987;122(7):784-789. doi:10.1001/archsurg.1987.01400190050010.
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• The effect of supplemental dietary arginine on metabolism and immunity was studied in 36 burned guinea pigs (30% of total body surface area) with previously placed catheter gastrostomies. The animals were randomized into four groups. After an initial three-day adaptation period, all groups received continuous isonitrogenous, isocaloric (175 kcal [735 kJ]/kg/d), and isovolemic intragastric tube feedings until postburn day (PBD) 14. Groups A, B, C, and D received 0%, 1%, 2%, and 4%, respectively, of total energy intake as arginine given in the form of crystalline arginine hydrochloride with 22%, 21%, 20%, and 18%, respectively, of total energy as whey protein. The average body weight after burn decreased equally in all groups. Resting metabolic expenditure on PBD 6 was higher in groups B (151%±6% of preburn) and C (156%±7%) than in groups A (131%±4%) and D (136%±3%). Ear-thickness response to dinitrofluorobenzene challenge on PBD 12 showed the best response in group C. The mortality rates of groups A, B, C, and D were 56%, 29%, 22%, and 56%, respectively. This study suggests that oral dietary arginine supplementation up to 2% of energy intake may be beneficial after burn injury.

(Arch Surg 1987;122:784-789)


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