The effect of amino-acid infusion during off-pump coronary arterial bypass surgery on thermogenic and hormonal regulation

Moriyama, Tsuyoshi; Tsuneyoshi, Isao; Omae, T; Takeyama, Masaharu; Kanmura, Yuichi

doi:10.1007/s00540-008-0651-1

Cited by 22 publications

(22 citation statements)

References 25 publications

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“…Other clinical studies also showed a marked rise in insulin level at the end of infusion of an amino acid mixture in the patients who underwent off-pump coronary artery bypass surgery under the propofol-anesthesia (34). Therefore, the increase in insulin level in the present study is considered attributable to the amino acid administration.…”

Section: Discussionsupporting

confidence: 60%

“…Our results showed hyperglycemia not only in the groups given AA but also in the groups given Sal (Table 3). Recent clinical studies demonstrated that rises in plasma insulin level due to amino acid infusion did not lead to hypoglycemia during surgery and amino acid infusion did not influence gluconeogenesis (34,39). Other animal studies reported that volatile anesthetics, such as sevoflurane and isoflurane, induced significant hyperglycemia in fed rats but isoflurane anesthesia did not cause an elevation of blood glucose to the hyperglycemic level in fasted rats (33,40).…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Amino Acid Infusion on Anesthesia-Induced Hypothermia in Muscle Atrophy Model Rats

Kanazawa

Ando

Tsuda

et al. 2010

J Nutr Sci Vitaminol

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Summary An infusion of amino acids stimulates heat production in skeletal muscle and then attenuates the anesthesia-induced hypothermia. However, in a clinical setting, some patients have atrophic skeletal muscle caused by various factors. The present study was therefore conducted to investigate the effect of amino acids on the anesthesia-induced hypothermia in the state of muscle atrophy. As the muscle atrophy model, Sprague-Dawley rats were subjected to hindlimb immobilization for 2 wk. Normal rats and atrophy model rats were randomly assigned to one of the two treatment groups: saline or amino acids ( n ϭ 8 for each group). Test solutions were administered intravenously to the rats under sevoflurane anesthesia for 180 min, and the rectal temperature was measured. Plasma samples were collected for measurement of insulin, blood glucose, and free amino acids. The rectal temperature was significantly higher in the normal-amino acid group than in the muscle atrophy-amino acid group from 75 to 180 min. The plasma insulin level was significantly higher in the rats given amino acids than in the rats given saline in both normal and model groups. In the rats given amino acids, plasma total free amino acid concentration was higher in the model group than in the normal group. These results indicate that skeletal muscle plays an important role in changes in body temperature during anesthesia and the effect of amino acids on anesthesia-induced hypothermia decreases in the muscle atrophy state. In addition, intravenous amino acids administration during anesthesia induces an increase in the plasma insulin level.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

The Effect of Amino Acid Infusion on Anesthesia-Induced Hypothermia in Muscle Atrophy Model Rats

Kanazawa

Ando

Tsuda

et al. 2010

J Nutr Sci Vitaminol

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“…Previous studies using male rats have shown that plasma insulin levels increase during general anesthesia after amino acid infusion (7,8,12,16). In the present study, the insulin level after administration of the test solution was significantly and consistently high in the OVX-AA group, in which a significant inhibitory effect on hypothermia was observed.…”

Section: Discussionsupporting

confidence: 60%

“…On the other hand, plasma insulin levels in our study are the values at the end of administration of the test solution. Because previous clinical studies have reported that an increase in insulin levels with the administration of amino acid mixture is transient (16), further studies are required to measure insulin levels over time during continuous administration of amino acids.…”

Section: Discussionmentioning

confidence: 99%

Effects of Intravenous Amino Acids on Anesthesia-Induced Hypothermia in Ovariectomized Rats

Ando

Kanazawa

Tsuda

et al. 2012

J Nutr Sci Vitaminol

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Summary A decrease in core temperature during general anesthesia is attenuated by infusion of an intravenous amino acid mixture. The purpose of the present study was to investigate the influence of physical and endocrine changes caused by ovariectomy on the inhibitory effect of amino acid infusion on anesthesia-induced hypothermia. Sprague-Dawley female rats were divided into a sham-operated (Sham) group and an ovariectomized (OVX) group. Saline solution or an amino acid mixture solution was infused for 180 min during sevoflurane anesthesia, and the rectal temperature was measured (4 groups). Intraperitoneal white adipose tissue mass, bilateral gastrocnemius weight and plasma insulin levels were measured. In the Sham rats, no inhibitory effect of the amino acid mixture on anesthesia-induced hypothermia was found, while in the OVX rats, hypothermia was significantly decreased. The intraperitoneal fat weight/body weight ratio was significantly higher in the OVX rats than in the Sham rats, but the gastrocnemius weight/body weight ratio was not significantly different. After amino acid infusion, the plasma insulin level was significantly higher in the OVX rats than in the Sham rats. In conclusion, our findings suggest that, in rats, ovarian function or female hormone affects protein turnover mediated by increase in insulin secretion and, thus, decreases the inhibitory effect of an infusion of amino acid mixture on anesthesia-induced hypothermia. Key Words hypothermia, amino acids, general anesthesia, ovariectomy Redistribution hypothermia occurs in the body after induction of general anesthesia. Core body temperature gradually declines as heat is lost from the body surface, and heat production slows because of decreased metabolism. Selldén et al. reported that an amino acid infusion during anesthesia caused nutrient-induced thermogenesis (NIT), preventing the temperature reduction of redistribution hypothermia ( 1 ). Fujiwara et al. noted a similar effect after amino acid infusion but not after an infusion of glucose and fat emulsion ( 2 ). It is known that the metabolism of amino acids requires a large expenditure of energy ( 3 ), and protein synthesis induced by amino acids has been shown to correlate positively with energy expenditure ( 4 ). When rats were given the protein synthesis inhibitor puromycin, NIT did not occur after amino acid infusion ( 5 ). It has also been suggested that 75% of the increased oxygen uptake by amino acid infusion is produced in tissues other than the internal organs ( 6 ). Amino acid infusion during general anesthesia was found to stimulate protein synthesis in skeletal muscle via enhanced insulin secretion and to prevent hypothermia by heat accumulation through NIT ( 7 ). We have reported that skeletal muscle and plasma insulin levels play a major role in changes in body temperature during general anesthesia and the effect of amino acids on body temperature in a rat model of muscle atrophy ( 8 ).On the other hand, sex hormone is known to be involved in thermoregulation. In addition,...

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“…The use of the present protocol did not increase surgical stress, as suggested by the similar urinary excretion of adrenaline observed in the two groups. The use of amino acids during the anesthesia period may be of advantage in terms of nitrogen metabolism and may increase thermogenesis, inhibiting hypothermia during the postoperative period [22] [23]. The total number of subjects studied was considered adequate because the full protocol was long, and experimental protocols with human beings are always difficult to perform and control.…”

Section: Discussionmentioning

confidence: 99%

Increased Nitrogen Retention after Trans-Operative Intravenous Amino Acid and Glucose Infusion, without Changes in Urinary Amino Acid, Adrenaline and Plasma Urea or Glucose

Albuquerque-Filho¹,

Júca²,

Padovan³

et al. 2014

Health

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Objective: Nutritional deficiencies are associated with increased morbidity and mortality during and after surgery. The present study evaluated nitrogen retention after transoperative intravenous infusion of amino acids and glucose. Design: Prospective study. Setting: Large community hospital. Patients: 18 randomly chosen patients undergoing medium or major surgeries. Interventions and Measurements: The experimental design included a 12-hour period before surgery (P1), a trans-operative period of 6 hours (P2), an early postoperative period (P3, 18 hours), and a late postoperative period (P4, 24 hours). Urinary amino acid and nitrogen were analyzed from P1 through P4. Group I, nine patients, received Ringer's lactate solution with 5% glucose, and Group II, another nine patients, received a 6.6% amino acid and 16.6% glucose solution over a 6-hour trans-operative period (P2) starting from the anesthesia procedures. All surgical procedures lasted a maximum of 3 hours. Results: There was no statistically significant difference in urinary amino acid or adrenaline excretion between P1 and P4 in either group. Nitrogen excretion values were also similar for both groups, i.e., 0.39 ± 0.16 and 0.39 ± 0.28 g/hour, respectively. The nitrogen balance showed greater nitrogen retention (−0.25 ± 0.24 g/hour) in the group receiving the amino acid infusion compared to the group receiving Ringer's lactate solution (−0.59 ± 0.26 * Corresponding author. E. T. Albuquerque-Filho et al. 1013g/hour) (P < 0.05). Blood plasma urea nitrogen and glycaemia did not increase at the end of the study (P4 period) in either group. Conclusion: These data indicate that trans-operative infusion of glucose and amino acids can be beneficial for patients submitted to surgical stress in terms of nitrogen retention.

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The effect of amino-acid infusion during off-pump coronary arterial bypass surgery on thermogenic and hormonal regulation

Cited by 22 publications

References 25 publications

The Effect of Amino Acid Infusion on Anesthesia-Induced Hypothermia in Muscle Atrophy Model Rats

The Effect of Amino Acid Infusion on Anesthesia-Induced Hypothermia in Muscle Atrophy Model Rats

Effects of Intravenous Amino Acids on Anesthesia-Induced Hypothermia in Ovariectomized Rats

Increased Nitrogen Retention after Trans-Operative Intravenous Amino Acid and Glucose Infusion, without Changes in Urinary Amino Acid, Adrenaline and Plasma Urea or Glucose

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