Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profile
Autor(a) principal: | |
---|---|
Data de Publicação: | 2017 |
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/10316/108292 https://doi.org/10.20960/nh.817 |
Resumo: | Background: Glutamine depletion is common in the critically-ill patients. Glutaminemia lower than 420 μmol/l has been considered as an independent predictive factor of mortality, but the indications for exogenous glutamine supplementation remain controversial. This study intends to determine the glutaminemia profi le in critical surgical patients and to investigate its correlation with the severity indexes and the prognosis. Methods: A prospective study of 28 adult critical surgical patients was performed. Plasma amino acid concentrations were quantifi ed, by ion exchange chromatography, at the moment of admission and at the fi rst and third days, and compared with those of 11 reference healthy individuals. Severity indexes and parameters of prognosis were registered. Results: In critical surgical patients, mean glutaminemia at admission was lower than that of control individuals (385.1 ± 123.1 versus 515 ± 57.9 μmol/l, p = 0.002) and decreased until the third day (p = 0.042). Prevalence of severe hypoglutaminemia (< 420 μmol/l) at admission was 64.3%. Baseline glutaminemia correlated with the Simplifi ed Acute Physiology Score II (SAPS II score) (Pearson’s correlation coeffi cient r = -39.4%, p = 0.042), and it was lower in cases of erythrocytes transfusion (339.9 ± 78.8 versus 454.9 ± 148.8 μmol/l, p = 0.013). Glutaminemia at the third day correlated with the duration of invasive ventilation support (r = -65%, p = 0 .012) and ICU stay (r = -66.5%, p = 0.009). Glutaminemia below 320 μmol/l, observed in 25% of the patients, was associated with higher in-hospital mortality (42.9 versus 19%, statistically not signifi cant [n.s.]) and lower actuarial survival (212.1 ± 77.9 versus 262.3 ± 32.4 days, n.s.). Conclusions: Those results underscore the relevance of hypoglutaminemia as an adverse predictive factor in the critical surgical patients. Determination of glutaminemia may contribute to a better defi nition of the indications for glutamine supplementation. |
id |
RCAP_fc60912797d43281b0bd972360621af5 |
---|---|
oai_identifier_str |
oai:estudogeral.uc.pt:10316/108292 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profileGlutaminemiaPlasma aminogramCritical patientsSurgeryPrognosisGlutaminemiaPlasma aminogramaPacientes críticosCirugíaPrognosiAdultAgedAged, 80 and overCritical CareCritical IllnessFemaleGlutamineHospital MortalityHumansMaleMiddle AgedPatientsProspective StudiesRespiration, ArtificialYoung AdultBackground: Glutamine depletion is common in the critically-ill patients. Glutaminemia lower than 420 μmol/l has been considered as an independent predictive factor of mortality, but the indications for exogenous glutamine supplementation remain controversial. This study intends to determine the glutaminemia profi le in critical surgical patients and to investigate its correlation with the severity indexes and the prognosis. Methods: A prospective study of 28 adult critical surgical patients was performed. Plasma amino acid concentrations were quantifi ed, by ion exchange chromatography, at the moment of admission and at the fi rst and third days, and compared with those of 11 reference healthy individuals. Severity indexes and parameters of prognosis were registered. Results: In critical surgical patients, mean glutaminemia at admission was lower than that of control individuals (385.1 ± 123.1 versus 515 ± 57.9 μmol/l, p = 0.002) and decreased until the third day (p = 0.042). Prevalence of severe hypoglutaminemia (< 420 μmol/l) at admission was 64.3%. Baseline glutaminemia correlated with the Simplifi ed Acute Physiology Score II (SAPS II score) (Pearson’s correlation coeffi cient r = -39.4%, p = 0.042), and it was lower in cases of erythrocytes transfusion (339.9 ± 78.8 versus 454.9 ± 148.8 μmol/l, p = 0.013). Glutaminemia at the third day correlated with the duration of invasive ventilation support (r = -65%, p = 0 .012) and ICU stay (r = -66.5%, p = 0.009). Glutaminemia below 320 μmol/l, observed in 25% of the patients, was associated with higher in-hospital mortality (42.9 versus 19%, statistically not signifi cant [n.s.]) and lower actuarial survival (212.1 ± 77.9 versus 262.3 ± 32.4 days, n.s.). Conclusions: Those results underscore the relevance of hypoglutaminemia as an adverse predictive factor in the critical surgical patients. Determination of glutaminemia may contribute to a better defi nition of the indications for glutamine supplementation.Introducción: la hipoglutaminemia es común en los pacientes críticos, pero las indicaciones para la suplementación con glutamina exógena siguen siendo controvertidas. Este estudio pretende determinar el perfi l de glutaminemia en pacientes quirúrgicos críticos e investigar su correlación con los índices de gravedad y el pronóstico. Métodos: se realizó un estudio prospectivo de 28 pacientes quirúrgicos críticos adultos. Las aminoacidemias se cuantifi caron mediante cromatografía de intercambio iónico en el momento del ingreso y en el primer y tercer día, y se compararon con las de 11 individuos sanos. Se registraron índices de gravedad y de pronóstico. Resultados: en pacientes quirúrgicos críticos, la glutaminemia media en el ingreso fue inferior a la de los controles (385,1 ± 123,1 versus 515 ± 57,9 μmol/l, p = 0,002) y disminuyó hasta el tercer día (p = 0,042). La prevalencia de hipoglutaminemia severa (< 420 μmol/l) en el ingreso fue de 64,3%. La glutaminemia basal se correlacionó con el SAPS II (r = -39,4%, p = 0,042), y fue menor en los casos de transfusión de eritrocitos (339,9 ± 78,8 versus 454,9 ± 148,8 μmol/l, p = 0,013). La glutamina al tercer día se correlacionó con la duración de la ventilación invasiva (r = -65%, p = 0,012) y de la estancia en la UCI (r = -66,5%, p = 0,009). La glutaminemia < 320 μmol/l, observada en el 25% de los pacientes, se asoció con mayor mortalidad hospitalaria (42,9 versus 19%, n.s.) y menor supervivencia actuarial (212,1 ± 77,9 versus 262,3 ± 32,4 días, n.s.). Conclusiones: estos resultados refuerzan la importancia de hipoglutaminemia como un factor predictivo adverso en los pacientes quirúrgicos críticos. La determinación de glutaminemia puede contribuir a una mejor defi nición de las indicaciones para la suplementación.ARAN Ediciones S.A.2017-07-28info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://hdl.handle.net/10316/108292http://hdl.handle.net/10316/108292https://doi.org/10.20960/nh.817eng1699-51980212-1611Costa, Beatriz PintoMartins, 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:RCAAP2023-08-23T10:02:01Zoai:estudogeral.uc.pt:10316/108292Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:24:35.717979Repositório 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 |
Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profile |
title |
Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profile |
spellingShingle |
Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profile Costa, Beatriz Pinto Glutaminemia Plasma aminogram Critical patients Surgery Prognosis Glutaminemia Plasma aminograma Pacientes críticos Cirugía Prognosi Adult Aged Aged, 80 and over Critical Care Critical Illness Female Glutamine Hospital Mortality Humans Male Middle Aged Patients Prospective Studies Respiration, Artificial Young Adult |
title_short |
Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profile |
title_full |
Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profile |
title_fullStr |
Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profile |
title_full_unstemmed |
Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profile |
title_sort |
Glutaminemia prognostic significance in critical surgical patients - An analysis of plasma aminogram profile |
author |
Costa, Beatriz Pinto |
author_facet |
Costa, Beatriz Pinto 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 Pinto Martins, Paulo Veríssimo, Carla Simões, Marta Tomé, Marisa Grazina, Manuela Pimentel, Jorge Sousa, Francisco Castro |
dc.subject.por.fl_str_mv |
Glutaminemia Plasma aminogram Critical patients Surgery Prognosis Glutaminemia Plasma aminograma Pacientes críticos Cirugía Prognosi Adult Aged Aged, 80 and over Critical Care Critical Illness Female Glutamine Hospital Mortality Humans Male Middle Aged Patients Prospective Studies Respiration, Artificial Young Adult |
topic |
Glutaminemia Plasma aminogram Critical patients Surgery Prognosis Glutaminemia Plasma aminograma Pacientes críticos Cirugía Prognosi Adult Aged Aged, 80 and over Critical Care Critical Illness Female Glutamine Hospital Mortality Humans Male Middle Aged Patients Prospective Studies Respiration, Artificial Young Adult |
description |
Background: Glutamine depletion is common in the critically-ill patients. Glutaminemia lower than 420 μmol/l has been considered as an independent predictive factor of mortality, but the indications for exogenous glutamine supplementation remain controversial. This study intends to determine the glutaminemia profi le in critical surgical patients and to investigate its correlation with the severity indexes and the prognosis. Methods: A prospective study of 28 adult critical surgical patients was performed. Plasma amino acid concentrations were quantifi ed, by ion exchange chromatography, at the moment of admission and at the fi rst and third days, and compared with those of 11 reference healthy individuals. Severity indexes and parameters of prognosis were registered. Results: In critical surgical patients, mean glutaminemia at admission was lower than that of control individuals (385.1 ± 123.1 versus 515 ± 57.9 μmol/l, p = 0.002) and decreased until the third day (p = 0.042). Prevalence of severe hypoglutaminemia (< 420 μmol/l) at admission was 64.3%. Baseline glutaminemia correlated with the Simplifi ed Acute Physiology Score II (SAPS II score) (Pearson’s correlation coeffi cient r = -39.4%, p = 0.042), and it was lower in cases of erythrocytes transfusion (339.9 ± 78.8 versus 454.9 ± 148.8 μmol/l, p = 0.013). Glutaminemia at the third day correlated with the duration of invasive ventilation support (r = -65%, p = 0 .012) and ICU stay (r = -66.5%, p = 0.009). Glutaminemia below 320 μmol/l, observed in 25% of the patients, was associated with higher in-hospital mortality (42.9 versus 19%, statistically not signifi cant [n.s.]) and lower actuarial survival (212.1 ± 77.9 versus 262.3 ± 32.4 days, n.s.). Conclusions: Those results underscore the relevance of hypoglutaminemia as an adverse predictive factor in the critical surgical patients. Determination of glutaminemia may contribute to a better defi nition of the indications for glutamine supplementation. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-07-28 |
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/10316/108292 http://hdl.handle.net/10316/108292 https://doi.org/10.20960/nh.817 |
url |
http://hdl.handle.net/10316/108292 https://doi.org/10.20960/nh.817 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1699-5198 0212-1611 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
ARAN Ediciones S.A. |
publisher.none.fl_str_mv |
ARAN Ediciones S.A. |
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 |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799134129942429696 |