Surgical trauma and postoperative nutrition:A longitudinal study of muscle protein metabolism

A catabolic state develops following surgical trau-ma.including weight loss and muscle wasting,whichleads to an increased loss of nitrogen in the urineThere is a decrease in muscle protein synthesis and anincreased translocation of amino acids from muscle tothe splanchnic area.This results in an impoverish-ment of muscle free amino acids.mainly GLN,andeventually impairment of muscle function which can-not be counteracted by conventional TPN.However,TPN supplemented with GLN improves nitrogen bal-