Nitrogen sparing effect of ornicetil ® in the immediate post-operative state—Plasma and muscle amino-acids

Abstract

In an earlier report we demonstrated that parenteral nutrition (TPN) with addition of 1(+)ornithine alpha-ketoglutarate (Ornicetil ®) markedly improved nitrogen economy in the immediate post-operative period compared to controls given isocaloric and isonitrogenous TPN but without Ornicetil ®. In the present study, plasma and intracellular muscle free amino-acid concentrations were measured in 13 patients before and 3 days after major elective abdominal surgery; seven patients without and six with Ornicetil ® supplementation. The pre-operative values for plasma and muscle free amino-acids did not differ from those derived from age matched health subjects. The direction of post-operative alterations in plasma amino-acid concentrations were similar in both groups, consistent with the earlier reported post-operative pattern, although the elevations of BCAA, proline and ornithine were much more accentuated in the Ornicetil ® group. After surgery the majority of the commonly observed intracellular changes were abolished or minimised in patients receiving Ornicetil ®, while the intracellular depletion of glutamine persisted and the levels of ornithine and proline were markedly elevated as a consequence of Ornicetil ® supply. A tentative explanation for the biochemical action of Ornicetil ® is given.