Ornithine alpha-Ketoglutarate (OKG) displays anabolic and anticatabolic properties in situations of stress. However, studies including both biological and clinical end points are scarce. In this prospective, randomized and double-blind study, 60 patients who had undergone severe burns (20-60% of body surface area) received either ornithine alpha-ketoglutarate (20 g/day) or an isocaloric placebo, for 21 days, starting mean 4 days after injury. In the OKG group, nitrogen balance reached positive values at d5 and stabilized at higher levels vs controls (P< 0.05 or less from day 3 to day 21), resulting in a strongly positive cumulated nitrogen balance at day 21 (mean +/- SEM, OKG group: +127 +/- 13;
Control group: -63 +/- 18g nitrogen). As measured at day 21, transthyretin and RBP levels were higher in the OKG group (respectively 259 +/- 9 vs 161 +/- 10, and 45 +/- 1 vs 33 +/- 1 mg/l, P< 0.001). Body weight loss was counteracted at d21 in the OKG group (-2.6% vs -6.3%, P< 0.001). Assessment of the quality of wound healing using objective scoring showed better performances in the OKG group (P< 0.05). The results suggest that improvement in nutritional parameters observed during the treatment of burn-injured patients with ornithine a-ketoglutarate allows better clinical recovery.