Research Article
Efficacy and Safety of Parenteral Amino Acids in Hospitalized Malnourished Patients: A Multicentric Case-Series
Sheth H1*, Mishra PK2, Sharma R3, Kumar M4 and Shukla H5
1Consultant Surgeon, Saifee Hospital, Apollo Spectra Hospital, Bhatia Hospital, Conwest Hospital & Manjula Badani Jain Hospital,
Mumbai, India
2Consultant Critical Care, Shree Aggarsain International Hospital, New Delhi, India
3Consultant Surgeon, New Delhi, India
4Medical Superintendent, Pushpanjali Medical Center, Delhi, India
5Consultant Oncosurgeon, BLK-Max Super specialty Hospital, New Delhi, India
*Corresponding author: Sheth H, Consultant Surgeon, Saifee Hospital, Apollo Spectra Hospital, Bhatia Hospital, Conwest Hospital
& Manjula Badani Jain Hospital, Mumbai, India; E-mail: harsh86sheth@gmail.com
Article Information: Submission: 06/08/2022; Accepted: 03/09/2022; Published: 05/09/2022
Copyright: © 2022 Sheth H, et al. This is an open access article distributed under the Creative Commons Attribution License, which
permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background & Objective: Globally, malnutrition in hospitalized patients is increasing, with prevalence up to 30-50%. It is associated with a higher risk of
adverse outcomes, including morbidity, mortality, length of hospital stay, and compromised quality of life. In India, almost two-fifths of the patients admitted to
tertiary care hospitals are reported to be malnourished. Studies have suggested using nutritional markers like serum pre-albumin (SPA) and visceral protein
markers like serum retinol-binding protein (S-RBP) to evaluate the nutrition status of malnourished patients. Guidelines recommend supplementing parenteral
amino acids to manage the protein status in hospitalized patients with malnutrition.
This case series study aims to demonstrate the efficacy and safety of parenteral amino acids in malnourished patients admitted to the hospital ward and
their impact on improving nutritional markers e.g., S-PA and S-RBP.
Methods: This multicentric case series study enrolled 80 patients admitted to the hospital ward across 49 Indian sites. Parenteral amino acid
supplementation was administered intravenously once daily for five days. The primary outcomes were changes in the nutritional laboratory markers S-PA and
S-RBP for improvement in nutritional status in enrolled malnourished patients.
Results: The pre-and post-assessment data for nutritional laboratory markers were available for 35 patients. A statistically significant increase was
observed in the levels of S-PA and S-RBP. Additionally, similar improvements were observed in a subgroup analysis of patients treated by intensivists.
Conclusion: The results from this case series demonstrated that administering parenteral amino acid significantly improves the nutritional laboratory
markers S-PA and S-RBP in hospitalized patients with malnutrition. A similar benefit was also observed in the subgroup of patients treated by the intensivists,
suggesting a positive role of parenteral amino acid supplementation in critically ill patients.