ExtractSignificant amino acid loss through the stool, analogous to impeded reabsorption of water, fat, and electrolytes, was suspected in infantile diarrhea. The stools of six patients, who had acute diarrhea and received no protein by mouth, were collected and analyzed for amino acids, nitrogen, and protein. Similar determinations were made on five normal controls. In addition, stool collections were made from one patient during a severe protracted diarrhea which necessitated parenteral alimentation, during a subsequent isolated acute episode of diarrhea, and after complete recovery. The results of the analyses showed that free amino acids in the stool are elevated up to 10-fold during diarrhea, as compared with periods of remission and with normal controls. Protein and total nitrogen excretion is also elevated in diarrhea, although to a lesser degree (4-and 2.5-fold, respectively). It is postulated that protracted diarrhea is associated with impaired reabsorption of endogenous nitrogen, which results in a vicious cycle of protein depletion that ultimately leads to an intractable stage. The validity of this assumption is confirmed by the success achieved by parenteral amino acid therapy for protracted diarrhea.
Biochemical aspects of total parenteral alimentation in 10 patients (two low birth weight newborn infants and eight infants) for periods of 5 to 24 days were studied by:
A. Determination of concentration of amino acids and ammonia of two commercially available protein hydrolysates.
B. Analyses of blood and urine obtained before, during, and after parenteral alimentation for various biochemical parameters including amino acids, urea nitrogen, glucose, and osmolality.
The results showed that the protein hydrolysates contained a very high concentration of ammonia.
This inordinate amount of ammonia taxes the Krebs urea cycle and in premature infants enhances acidosis and respiratory distress syndrome. It also explains the abnormal liver function tests and hyperammonemia found concomitantly with infusion of protein hydrolysate. Another effect of infusion of protein hydrolysate, in conventional amount, is persistent hyperaminoacidemia.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.