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Anesth Analg 2006;103:1386-1393
© 2006 International Anesthesia Research Society
doi: 10.1213/01.ane.0000240972.84337.7c

CARDIOVASCULAR ANESTHESIA

Perioperative Amino Acid Infusion Improves Recovery and Shortens the Duration of Hospitalization After Off-Pump Coronary Artery Bypass Grafting

Takako Umenai, MD*, Yasufumi Nakajima, MD, PhD*, Daniel I. Sessler, MD{dagger}{ddagger}, Satoshi Taniguchi, MD*, Hitoshi Yaku, MD, PhD||, and Toshiki Mizobe, MD, PhD*

From the *Department of Anesthesiology, Kyoto Prefectural University of Medicine, Japan; {dagger}Department of Outcomes Research, Cleveland Clinic Foundation, Cleveland, Ohio; {ddagger}Outcomes Research Institute, and Department of Anesthesiology, University of Louisville, Kentucky; and ||Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Japan.

Address correspondence and reprint requests to Yasufumi Nakajima, MD, PhD, Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. Address e-mail to nakajima{at}koto.kpu-m.ac.jp.

Perioperative amino acid infusion helps maintain core temperature and improves patient outcomes after gynecologic and orthopedic surgery. In the present study we prospectively determined the effect of amino acid infusion on esophageal core temperature and postoperative outcomes during off-pump coronary artery bypass grafting (CABG). One-hundred-eighty consecutive patients undergoing primary elective or urgent off-pump CABG were randomly divided into two groups: the IV amino acid infusion group (4 kJ kg–1 h–1 starting 2 h before surgery) and the saline infusion group (similar period and volume of saline infusion). The esophageal core temperature at the end of surgery was 35.6 (35.3–35.8)°C [mean (95% confidence interval)] in the saline infusion group and 36.1°C (35.9–36.3)°C in the amino acid infusion group (P = 0.01). Kaplan–Meier analysis demonstrated that patients given amino acids required a significantly shorter duration of postoperative mechanical ventilation than patients given saline [median (95% confidence interval), 3.0 (2.5–3.9) vs 4.5 (3.8–5.8) h; P = 0.01]. Furthermore, intensive care unit stay [20 (19.5–38.4) vs 44 (21–45) h; P = 0.001] and days until fit for discharge from hospital [10 (9–11) vs 12 (11–13) days; P = 0.004] were significantly shorter in patients given amino acid. Perioperative amino acid infusion in patients undergoing off-pump CABG effectively minimizes intraoperative hypothermia and improves postoperative recovery.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2006 by the International Anesthesia Research Society.