Metabolism of Proteins and Amino Acids in Critical Illness: From Physiological Alterations to Relevant Clinical Practice

Abstract

Chih-Chieh Hsu,1 Ci-Yuan Sun,2 Chun-Yi Tsai,1 Ming-Yang Chen,1 Shang-Yu Wang,1,3 Jun-Te Hsu,1,3 Chun-Nan Yeh,1,3 Ta-Sen Yeh1,3 1Division of General Surgery, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan; 2Division of Colon & Rectal Surgery, Chang Gung Memorial Hospital, Taoyuan, 333, Taiwan; 3Chang Gung University, Taoyuan, 333, TaiwanCorrespondence: Shang-Yu Wang Email [email protected]: The clinical impact of nutrition therapy in critically ill patients has been known for years, and relevant guidelines regarding nutrition therapy have emphasized the importance of proteins. During critical illness, such as sepsis or the state following major surgery, major trauma, or major burn injury, patients suffer from a high degree of stress/inflammation, and during this time, metabolism deviates from homeostasis. The increased degradation of endogenous proteins in response to stress hormones is among the most important events in the acute phase of critical illness. Currently published evidence suggests that adequate protein supplementation might improve the clinical outcomes of critically ill patients. The role of sufficient protein supplementation may even surpass that of caloric supplementation. In this review, we focus on relevant physiological alterations in critical illness, the effects of critical illness on protein metabolism, nutrition therapy in clinical practice, and the function of specific amino acids.Keywords: critical illness, protein, metabolism, amino acid

Keywords

• critical illness
• protein
• metabolism
• amino acid