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Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome

Low and high plasma glutamine levels are associated with increased mortality. This study aimed to measure glutamine levels in critically ill patients admitted to the intensive care unit (ICU), correlate the glutamine values with clinical outcomes, and identify proxy indicators of abnormal glutamine...

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Autores principales: Blaauw, Renée, Nel, Daan G., Schleicher, Gunter K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071267/
https://www.ncbi.nlm.nih.gov/pubmed/32028696
http://dx.doi.org/10.3390/nu12020402
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author Blaauw, Renée
Nel, Daan G.
Schleicher, Gunter K.
author_facet Blaauw, Renée
Nel, Daan G.
Schleicher, Gunter K.
author_sort Blaauw, Renée
collection PubMed
description Low and high plasma glutamine levels are associated with increased mortality. This study aimed to measure glutamine levels in critically ill patients admitted to the intensive care unit (ICU), correlate the glutamine values with clinical outcomes, and identify proxy indicators of abnormal glutamine levels. Patients were enrolled from three ICUs in South Africa, provided they met the inclusion criteria. Clinical and biochemical data were collected. Plasma glutamine was categorized as low (<420 µmol/L), normal (420–700 µmol/L), or high (>700 µmol/L). Three hundred and thirty patients (median age 46.8 years, 56.4% male) were enrolled (median APACHE II score) 18.0 and SOFA) score 7.0). On admission, 58.5% had low (median 299.5 µmol/L) and 14.2% high (median 898.9 µmol/L) plasma glutamine levels. Patients with a diagnosis of polytrauma and sepsis on ICU admission presented with the lowest, and those with liver failure had the highest glutamine levels. Admission low plasma glutamine was associated with higher APACHE II scores (p = 0.003), SOFA scores (p = 0.003), C-reactive protein (CRP) values (p < 0.001), serum urea (p = 0.008), and serum creatinine (p = 0.023) and lower serum albumin (p < 0.001). Low plasma glutamine was also associated with requiring mechanical ventilation and receiving nutritional support. However, it was not significantly associated with length of stay or mortality. ROC curve analysis revealed a CRP threshold value of 87.9 mg/L to be indicative of low plasma glutamine levels (area under the curve (AUC) 0.7, p < 0.001). Fifty-nine percent of ICU patients had low plasma glutamine on admission, with significant differences found between diagnostic groupings. Markers of infection and disease severity were significant indicators of low plasma glutamine.
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spelling pubmed-70712672020-03-19 Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome Blaauw, Renée Nel, Daan G. Schleicher, Gunter K. Nutrients Article Low and high plasma glutamine levels are associated with increased mortality. This study aimed to measure glutamine levels in critically ill patients admitted to the intensive care unit (ICU), correlate the glutamine values with clinical outcomes, and identify proxy indicators of abnormal glutamine levels. Patients were enrolled from three ICUs in South Africa, provided they met the inclusion criteria. Clinical and biochemical data were collected. Plasma glutamine was categorized as low (<420 µmol/L), normal (420–700 µmol/L), or high (>700 µmol/L). Three hundred and thirty patients (median age 46.8 years, 56.4% male) were enrolled (median APACHE II score) 18.0 and SOFA) score 7.0). On admission, 58.5% had low (median 299.5 µmol/L) and 14.2% high (median 898.9 µmol/L) plasma glutamine levels. Patients with a diagnosis of polytrauma and sepsis on ICU admission presented with the lowest, and those with liver failure had the highest glutamine levels. Admission low plasma glutamine was associated with higher APACHE II scores (p = 0.003), SOFA scores (p = 0.003), C-reactive protein (CRP) values (p < 0.001), serum urea (p = 0.008), and serum creatinine (p = 0.023) and lower serum albumin (p < 0.001). Low plasma glutamine was also associated with requiring mechanical ventilation and receiving nutritional support. However, it was not significantly associated with length of stay or mortality. ROC curve analysis revealed a CRP threshold value of 87.9 mg/L to be indicative of low plasma glutamine levels (area under the curve (AUC) 0.7, p < 0.001). Fifty-nine percent of ICU patients had low plasma glutamine on admission, with significant differences found between diagnostic groupings. Markers of infection and disease severity were significant indicators of low plasma glutamine. MDPI 2020-02-03 /pmc/articles/PMC7071267/ /pubmed/32028696 http://dx.doi.org/10.3390/nu12020402 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Blaauw, Renée
Nel, Daan G.
Schleicher, Gunter K.
Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome
title Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome
title_full Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome
title_fullStr Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome
title_full_unstemmed Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome
title_short Plasma Glutamine Levels in Relation to Intensive Care Unit Patient Outcome
title_sort plasma glutamine levels in relation to intensive care unit patient outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7071267/
https://www.ncbi.nlm.nih.gov/pubmed/32028696
http://dx.doi.org/10.3390/nu12020402
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