Portal glucose delivery stimulates muscle but not liver protein metabolism

Sarcopenia is a prognostic factor in living donor liver transplantation

“…21 Besides, it has recently been reported that portal glucose delivery stimulated not liver but instead muscle protein synthesis in an in vivo study. 22 Protein synthesis in patients with sarcopenia must be lower than that in patients without sarcopenia. Now, a prospective study using early enteral nutrition with or without glutamine is being planned and promoted.…”

“…Glutamine is an important nutrient in constructing the intestinal wall: a decrease in glutamine can weaken the intestinal wall, and postoperative sepsis due to bacterial translocation may occur . Besides, it has recently been reported that portal glucose delivery stimulated not liver but instead muscle protein synthesis in an in vivo study . Protein synthesis in patients with sarcopenia must be lower than that in patients without sarcopenia.…”

Profile of plasma amino acids values as a predictor of sepsis in patients following living donor liver transplantation: Special reference to sarcopenia and postoperative early nutrition

“…Associations with plasma glutamine levels and a life‐threatening infection such as sepsis have been reported for patients after surgery or liver transplantation . Glutamine has many important metabolic roles that protect or promote muscle mass and enhance the immune system . Glutamine depletion decreases the proliferation of lymphocytes, which weakens the immune system .…”

“…It influences the cellular water content and has multiple effects on the immune system, intestinal functions and protein metabolism. Glutamine is also a precursor for the synthesis of glutathione, a powerful natural antioxidant enzyme that stimulates the formation of heat‐shock proteins . A deficiency of glutamine may promote fatal sepsis after LDLT, especially when patients, such as those with sarcopenia who have poor glutamine metabolism in skeletal muscle, are routinely treated with immunosuppressants.…”

Should enteral nutrition be started in the first week of critical illness?

“…The patients receiving calories in the middle third had better outcome, when compared with either those getting full calories or those in lower third of caloric delivery. These benefits have been reported in both animal and human models [16,17]. Use of the concentrated formula resulted in greater calorie delivery, at 27.3 AE 7.4 versus 19 AE 6 kcal/kg/day in the 1.0 kcal/ml group (P < 0.001).…”