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Both high and low plasma glutamine levels predict mortality in critically ill patients

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Abstract

Purpose

Plasma amino acids are important indicators for understanding human kinetics and amino acid dynamics. We aimed to investigate the association between the plasma glutamine levels and the mortality rates and determine whether plasma glutamine can predict the prognosis of critically ill patients.

Methods

The clinical records of adult patients who were admitted to an ICU were retrospectively evaluated to investigate the plasma levels of amino acids, including glutamine.

Results

Two hundred fourteen patients were included in this study (male, 62%; median age, 64 years; range 20–97 years). The patients’ diagnoses included sepsis (45%), trauma (14%), cardiovascular disease (9%), fulminant hepatitis (9%), burns (4%), and others (19%). The mortality rates in patients with plasma glutamine <400 nmol/mL (group L; 39%, 28/71) or ≥700 nmol/mL (group H; 50%, 15/30) were significantly higher (p < 0.05 and p < 0.01, respectively) than those in patients with plasma glutamine levels of 400–700 nmol/mL (group M; 21%, 24/113). Among patients with sepsis, the mortality rates of group L (46%) and group H (67%) were significantly higher (p < 0.05 or p < 0.01, respectively) in comparison with group M (26%).

Conclusion

Both lower and higher plasma glutamine levels were risk factors for mortality in critically ill patients.

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Author Contributions

T. Tsujimoto carried out the studies and was responsible for the conception, design, and data collection, the interpretation of the results, writing, and the reviewing of the manuscript. KS contributed to the sample analysis, the interpretation of the results, and the reviewing of the manuscript. NH contributed to the statistical analyses and the interpretation of the results. T. Takagi performed the statistical analyses and the interpretation of the results. EU participated in the reviewing of the manuscript. HO was involved in the interpretation of the results. MW contributed to the conception and design of the study, the interpretation of the results, and the reviewing of the manuscript. TS contributed to the supervision of the study.

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Authors and Affiliations

  1. Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe, Hyogo, Japan

    Takae Tsujimoto

  2. Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka, Japan

    Takae Tsujimoto, Tatsuya Takagi & Etsuko Uejima

  3. Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, Japan

    Kentaro Shimizu, Hiroshi Ogura & Takeshi Shimazu

  4. Nutrition Support Service, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, Japan

    Nobuaki Hata & Masafumi Wasa

Authors
  1. Takae Tsujimoto
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  2. Kentaro Shimizu
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  3. Nobuaki Hata
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  4. Tatsuya Takagi
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  7. Masafumi Wasa
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  8. Takeshi Shimazu
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Corresponding author

Correspondence to Takae Tsujimoto.

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The authors declare no conflicts of interest in association with the present study.

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Tsujimoto, T., Shimizu, K., Hata, N. et al. Both high and low plasma glutamine levels predict mortality in critically ill patients. Surg Today 47, 1331–1338 (2017). https://doi.org/10.1007/s00595-017-1511-0

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  • DOI: https://doi.org/10.1007/s00595-017-1511-0

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