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GENERAL ARTICLES

Amino Acid-Induced Thermogenesis Reduces Hypothermia During Anesthesia and Shortens Hospital Stay

Department of Anesthesiology and Intensive Care, Karolinska Hospital, Stockholm, Sweden

Address correspondence and reprint requests to Dr. Eva Selldén, Department of Anesthesiology and Intensive Care, Karolinska Hospital, S-171 76 Stockholm, Sweden.

Amino acid infusion during general anesthesia induces thermogenesis and prevents postoperative hypothermia and shivering. We propose that amino acid prevention of hypothermia during anesthesia shortens the hospital stay. Core temperatures and pulmonary oxygen uptake were measured in 45 patients, receiving an IV amino acid mixture, 126 mL/h, before and/or during isoflurane anesthesia and 30 control patients receiving acetated Ringer’s solution. At awakening, mean core temperature was 36.5° ± 0.1°C in the amino acid group and 35.7° ± 0.1°C (P < 0.001) in the controls. Energy expenditure increased by 54% ± 9% from baseline in amino acid patients in whom shivering was uncommon, but only by 5% ± 4% (P < 0.001) in control patients, of whom the majority developed postoperative shivering. The estimated difference in hospital stay between the two groups was 2.7 days (CI 95%: 1.3–4.0). Multiple regression analysis showed that the variables best predicting hospitalization were duration of surgery, amino acid treatment, and awakening temperatures. Duration of surgery was similar in the two groups and core temperatures at awakening were a result of amino acid infusion, which indicates that amino acid infusion during anesthesia and surgery was the most important factor for the shorter hospitalization.

Implications: Amino acid infusion during general anesthesia induces thermogenesis and prevents postoperative hypothermia and shivering. Multiple regression analysis indicated that this resulted in a shorter hospital stay.

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