Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients?
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10316/108730 https://doi.org/10.1186/s12986-016-0118-6 |
Resumo: | Background: Arginine is an amino acid determinant in the metabolic, immune and reparative responses to severe trauma. The present study aims to determine argininemia and plasma arginine bioavailability (PAB) in critical trauma patients and to analyze its correlation with prognosis. Methods: A prospective study of 23 critical trauma patients was undertaken. Aminoacidemias were determined, by ion exchange chromatography, at admission and in the first and third days and compared with those of 11 healthy individuals. PAB was calculated. Severity indexes and outcome parameters were recorded. Results: Values of argininemia, citrullinemia and ornithinemia at the admission were significantly lower than those of the controls (arginine: 41.2 ± 20.6 versus 56.1 ± 11.9 μmol/L, P = 0.034). Hipoargininemia (<60 μmol/L) prevalence was 82.6 %. Mean PAB was 62.4 ± 25.6 %. Argininemia < 26 μmol/L constituted a significant predictive factor of in-hospital mortality [n = 4 (17.4 %); 75 versus 15.8 %, P= 0.04; odds ratio = 4.7; accuracy = 87 %] and lower actuarial survival (63.5 ± 43.9 versus 256.1 ± 33.3 days, P= 0.031). PAB <42 % [n = 6 (26.1 %)] was associated with higher lactacidemia levels (P= 0. 033), higher in-hospital mortality (66.7 versus 11.8 %, P = 0.021; odds ratio = 5.7, accuracy = 82.6 %) and lower actuarial survival (87.2 ± 37.5 versus 261.4 ± 34.7 days, n.s.). Probability of in-hospital mortality was inversely and significantly related with PAB [61.8 ± 8.8 % (95 % CI 50.8–72.7) when PAB <41 % and 2.8 ± 1.9 % (95 % CI 1.9–8.3) when PAB > 81 %, P =0. 0001]. Charlson’s index ≥1, APACHE II ≥19.5, SOFA ≥7.5, and glutaminemia < 320 μmol/L were also predictive factors of actuarial survival. Conclusions: Those results confirm the high prevalence of arginine depletion in severe trauma patients and the relevance of argininemia and PAB as predictive factors of mortality in this context. |
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Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients?ArgininePlasma arginine bioavailabilityTraumaMortalityCritically ill patientsBackground: Arginine is an amino acid determinant in the metabolic, immune and reparative responses to severe trauma. The present study aims to determine argininemia and plasma arginine bioavailability (PAB) in critical trauma patients and to analyze its correlation with prognosis. Methods: A prospective study of 23 critical trauma patients was undertaken. Aminoacidemias were determined, by ion exchange chromatography, at admission and in the first and third days and compared with those of 11 healthy individuals. PAB was calculated. Severity indexes and outcome parameters were recorded. Results: Values of argininemia, citrullinemia and ornithinemia at the admission were significantly lower than those of the controls (arginine: 41.2 ± 20.6 versus 56.1 ± 11.9 μmol/L, P = 0.034). Hipoargininemia (<60 μmol/L) prevalence was 82.6 %. Mean PAB was 62.4 ± 25.6 %. Argininemia < 26 μmol/L constituted a significant predictive factor of in-hospital mortality [n = 4 (17.4 %); 75 versus 15.8 %, P= 0.04; odds ratio = 4.7; accuracy = 87 %] and lower actuarial survival (63.5 ± 43.9 versus 256.1 ± 33.3 days, P= 0.031). PAB <42 % [n = 6 (26.1 %)] was associated with higher lactacidemia levels (P= 0. 033), higher in-hospital mortality (66.7 versus 11.8 %, P = 0.021; odds ratio = 5.7, accuracy = 82.6 %) and lower actuarial survival (87.2 ± 37.5 versus 261.4 ± 34.7 days, n.s.). Probability of in-hospital mortality was inversely and significantly related with PAB [61.8 ± 8.8 % (95 % CI 50.8–72.7) when PAB <41 % and 2.8 ± 1.9 % (95 % CI 1.9–8.3) when PAB > 81 %, P =0. 0001]. Charlson’s index ≥1, APACHE II ≥19.5, SOFA ≥7.5, and glutaminemia < 320 μmol/L were also predictive factors of actuarial survival. Conclusions: Those results confirm the high prevalence of arginine depletion in severe trauma patients and the relevance of argininemia and PAB as predictive factors of mortality in this context.Springer Nature2016info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://hdl.handle.net/10316/108730http://hdl.handle.net/10316/108730https://doi.org/10.1186/s12986-016-0118-6eng1743-7075Costa, Beatriz P.Martins, PauloVeríssimo, CarlaSimões, MartaTomé, MarisaGrazina, ManuelaPimentel, JorgeSousa, Francisco Castroinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-09-11T09:58:40Zoai:estudogeral.uc.pt:10316/108730Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:25:00.023458Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients? |
title |
Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients? |
spellingShingle |
Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients? Costa, Beatriz P. Arginine Plasma arginine bioavailability Trauma Mortality Critically ill patients |
title_short |
Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients? |
title_full |
Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients? |
title_fullStr |
Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients? |
title_full_unstemmed |
Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients? |
title_sort |
Argininemia and plasma arginine bioavailability - predictive factors of mortality in the severe trauma patients? |
author |
Costa, Beatriz P. |
author_facet |
Costa, Beatriz P. Martins, Paulo Veríssimo, Carla Simões, Marta Tomé, Marisa Grazina, Manuela Pimentel, Jorge Sousa, Francisco Castro |
author_role |
author |
author2 |
Martins, Paulo Veríssimo, Carla Simões, Marta Tomé, Marisa Grazina, Manuela Pimentel, Jorge Sousa, Francisco Castro |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Costa, Beatriz P. Martins, Paulo Veríssimo, Carla Simões, Marta Tomé, Marisa Grazina, Manuela Pimentel, Jorge Sousa, Francisco Castro |
dc.subject.por.fl_str_mv |
Arginine Plasma arginine bioavailability Trauma Mortality Critically ill patients |
topic |
Arginine Plasma arginine bioavailability Trauma Mortality Critically ill patients |
description |
Background: Arginine is an amino acid determinant in the metabolic, immune and reparative responses to severe trauma. The present study aims to determine argininemia and plasma arginine bioavailability (PAB) in critical trauma patients and to analyze its correlation with prognosis. Methods: A prospective study of 23 critical trauma patients was undertaken. Aminoacidemias were determined, by ion exchange chromatography, at admission and in the first and third days and compared with those of 11 healthy individuals. PAB was calculated. Severity indexes and outcome parameters were recorded. Results: Values of argininemia, citrullinemia and ornithinemia at the admission were significantly lower than those of the controls (arginine: 41.2 ± 20.6 versus 56.1 ± 11.9 μmol/L, P = 0.034). Hipoargininemia (<60 μmol/L) prevalence was 82.6 %. Mean PAB was 62.4 ± 25.6 %. Argininemia < 26 μmol/L constituted a significant predictive factor of in-hospital mortality [n = 4 (17.4 %); 75 versus 15.8 %, P= 0.04; odds ratio = 4.7; accuracy = 87 %] and lower actuarial survival (63.5 ± 43.9 versus 256.1 ± 33.3 days, P= 0.031). PAB <42 % [n = 6 (26.1 %)] was associated with higher lactacidemia levels (P= 0. 033), higher in-hospital mortality (66.7 versus 11.8 %, P = 0.021; odds ratio = 5.7, accuracy = 82.6 %) and lower actuarial survival (87.2 ± 37.5 versus 261.4 ± 34.7 days, n.s.). Probability of in-hospital mortality was inversely and significantly related with PAB [61.8 ± 8.8 % (95 % CI 50.8–72.7) when PAB <41 % and 2.8 ± 1.9 % (95 % CI 1.9–8.3) when PAB > 81 %, P =0. 0001]. Charlson’s index ≥1, APACHE II ≥19.5, SOFA ≥7.5, and glutaminemia < 320 μmol/L were also predictive factors of actuarial survival. Conclusions: Those results confirm the high prevalence of arginine depletion in severe trauma patients and the relevance of argininemia and PAB as predictive factors of mortality in this context. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10316/108730 http://hdl.handle.net/10316/108730 https://doi.org/10.1186/s12986-016-0118-6 |
url |
http://hdl.handle.net/10316/108730 https://doi.org/10.1186/s12986-016-0118-6 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1743-7075 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Springer Nature |
publisher.none.fl_str_mv |
Springer Nature |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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