Nutritional intervention high in vitamins, protein, amino acids, and omega3 fatty acids improves protein metabolism during the hypermetabolic state after thermal injury

Hypothesis: Characteristic of the hypermetabolic response to a thermal inju ry is the massive protein catabolism and compromised structure and function of essential organs. Nutrition has been suggested to affect protein metabo lism and clinical outcome after a severe injury but published studies show controversial data. The purpose of this study was to determine the effect o f enriched nutritional support during the postburn hypermetabolic state on protein metabolism in serum, liver, muscle, and skin. Setting: Laboratory. Intervention: Twenty-two rats were given burns covering 60% of their total body surface area and randomized to receive either standard rat chow (contr ol) or a diet high in vitamins, protein, amino acids, and omega3 fatty acid s. Main Outcome Measures: Five weeks after injury. body weight, serum, muscle, and hepatic protein content,. insulin-like growth factor I concentration, and wound healing (reepithelization) were determined. Results: Rats receiving the enriched diet showed a gradual improvement in b ody weight 1, 2, 3, 4, and 5 weeks postburn compared with controls (P < .00 1). Diet-fed rats demonstrated higher protein and insulin-like growth facto r I content in serum, muscle, and liver 5 weeks after trauma (P < .001). Se rum protein, albumin, and transferrin levels were significantly increased i n rats receiving the diet compared with control rats (P < .001). Reepitheli zation was accelerated in rats receiving the enriched diet 4 (diet-fed, mea nt SD, 23% +/- 1% vs controls, 17% +/- 1% P < .001) and 5 (diet-fed, 24% +/ - 1% vs controls, 18% +/- 1%; P < .001) weeks postburn compared with contro l rats. Conclusions: Nutritional intervention high in protein, vitamins, amino acid s, and omega3 fatty acids improves protein net balance during the hypermeta bolic response to thermal injury. Compromised organ function and structure and clinical outcome during the hypermetabolic response may be improved.