PROTIENS IN SURGICAL PATIENTS

Proteins-Summary & Basic information 1
Protein is the most important nutrient because it is required for all body building functions. The utilization of protein as a source of energy is physiologically wasteful.
Amino acids are utilized in three major ways by the body:
1) Protein synthesis
2) Catabolic reactions leading to either urea or carbon dioxide, and
3) Synthesis of nonessential amino acids and other small molecules

Essential amino acids have a carbon skeleton that cannot be synthesized by the body, but requires an external source, i.e. valine, Lucien, isoleucine, lysine, methionine, phenylalanine, threonine, and tryptophan.

Thus, in critical illness, the majority of amino acids are either essential or conditionally indispensable.

Muscle stores of amino acid
Skeletal muscle contains most of the amino acids in the body.
Glutamate comprises 50% to 60% of all white fast-twitch and mixed muscles.
Within 20 hours of an operative procedure or trauma, a large portion of the glutamate store has been depleted.
The importance, of this phenomenon of rapid depletion, followed by slow refilling of glutamate stores is unclear at this time.
Some success has been achieved in preventing glutamate depletion by using glutamate supplementation.
Protein synthesis is modulated by insulin, amino acid supplementation, branched-chain amino acid concentration, and likely human growth hormone, somatomedin, and insulin-like growth factor.
Normally 60% to 100% of daily nitrogen retention is due to the postprandial branched chain amino acid uptake into skeletal muscle.
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