Prospective randomized, placebo-controlled study: role of branched-chain amino acids infusion as adjunct therapy post-liver surgery for patients in the intensive care unit.

Background and aim: Several animal studies have shown that Branched-chain amino acids (BCAAs) may prevent acute liver injury, although its effects in humans are as yet undetermined. Thus the purpose of this study is to evaluate the impact of intravenous BCAAs infusion on liver profile post-liver surgery in the intensive care unit (ICU).

Methods: A randomized study that was applied for post liver surgery patients who were randomly allocated to receive either intravenous BCAA immediately post-operative or placebo.

Measurements: Follow-up liver profile, Child-Pugh, and SOFA scores during the first week post-surgery.

Main results: A significant decline of bilirubin and ALT on day three and five in the BCAA group compared to the control group respectively. There was a significant improvement of PT on day seven 12.5 in the BCAA group versus 12.9 in the control group, p-value 0.01. Total bilirubin levels decreased by 75% in the BCAA group, whereas in the control group saw an increase of 6.25% from the baseline which was statistically significant, p-value 0.0376. SOFA score was markedly improved in the BCAA group (p-value 0.013). In addition to a significantly shorter ICU stay in the BCAA group than in the control group (p-value 0.018).

Conclusion: There are beneficial effects of BCAAs infusion post-liver surgery; including improved metabolic profile (liver function tests), and shorter ICU stay.

Trial registration: (Clinicaltrials.gov registration number:NCT03448848), 28/02/2018.