[Postoperative amino acid metabolism].

According to literature, anabolism is present in the visceral organs also during stress and early poststress-periods. During early periods of fasting, those enzyme structures of the visceral organs which are of prime importance are being catabolized. Therefore, an adequate nutrition is not only reasonable, but obligatory especially in those patients severely ill. As for the parenteral management of protein nutrition, solutions of L-amino acids (a.a.) are the only types suitable. These solutions should contain at least proportionate quantities of the 8 essential a.a., histidine, arginine, proline, alanine, glutamic acid and glycine with each single a.a. being within the respective physiologic regulation range. Different pattern of the a.a. requirement of adults are being established for different metabolic conditions. These types of a.a. pattern are highly dependent on the alterations of the functional requirement of one or more a.a. For the clinical need of total parenteral nutrition (t.p.n.) of adults, at least 3 types of different compositions of L-a.a. solution should be available: a) a standard a.a. solution (adapted to the physiologic requirement of adults) for long-term t.p.m. b) an a.a. solution with a high E/T-ratio for the t.p.n. of uremic patients (this solution is the one also used for t.p.n. of infants), c) an a.a. solution with high concentrations of branched-chain a.a. for the therapy of portosystemic encephalopathy. The metabolic significant and clinical importance of other special a.a. solutions are discussed.