The metabolic effects of post-sepsis feeding of meals with only essential amino acids

Nutritional support is a vital component of the rehabilitation process following sepsis. Essential amino acids (EAA) are recognized as a critical component for stimulating anabolism. However, it remains unclear whether EAA supplementation alone is more effective than providing a complete profile of all amino acids (TAA). We studied amino acid metabolism in 51 catheterized pigs (±27kg) using the pulse tracer approach over a 7-day recovery period following sepsis. Animals were randomly and blindly assigned to receive post-sepsis nutrition containing either an EAA or a TAA mixture based on the composition of pig muscle. Statistical analyses were performed using a generalized linear mixed model. Plasma concentrations of EAA increased substantially in the EAA group post-sepsis (interaction effect, p0.001), while those of non-essential amino acids increased in both groups (time effect, p0.001). Whole body intracellular production of most AA was reduced on day 3 and remained low on day 7 post-sepsis, with only small differences observed between the two groups. On day 7 post-sepsis, pigs receiving only EAA showed significantly (all p0.001) lower intracellular production of hydroxyproline (-36%), ornithine (-11%), and tryptophan (-20%) and higher production of arginine (66%), citrulline (18%), glutamine (18%), taurine (22%) and some EAA. The EAA group showed a significantly higher net protein breakdown post-sepsis. In this sepsis-recovery pig model, dietary supplementation of both EAA and TAA failed to normalize the intracellular production of amino acids. More importantly, providing only EAA resulted in a significantly greater net protein breakdown compared to the TAA group.