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Blood Glutamate Reducing Effect of Hemofiltration in Critically Ill Patients

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Abstract

Glutamate toxicity plays a well-established role in secondary brain damage following acute and chronic brain insults. Previous studies have demonstrated the efficacy of hemodialysis and peritoneal dialysis in reducing blood glutamate levels. However, these methods are not viable options for hemodynamically unstable patients. Given more favorable hemodynamics, longer treatment, and less needed anticoagulation, we investigated whether hemofiltration could be effective in lowering blood glutamate levels. Blood samples were taken from 10 critically ill patients immediately before initiation of hemofiltration and after 1, 2, 4, 6, and 12 h, for a total of 6 blood samples. Samples were sent for determination of glutamate, glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), hemoglobin, hematocrit, urea, creatinine, glucose, sodium, potassium, platelet, and white blood cell (WBC) levels. There was a statistically significant reduction in blood glutamate levels at all time points compared to baseline levels. There was no difference in levels of GOT or GPT. Hemofiltration can be a promising method of reducing blood glutamate levels, especially in critically ill patients where hemodialysis and peritoneal dialysis may be contraindicated.

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Author notes

  1. Evgeni Brotfain and Ruslan Kutz equally contributed to this work.

Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Evgeni Brotfain, Ruslan Kutz, Julia Grinshpun, Amit Frenkel, Yoav Bichovsky, Matthew Boyko, Moti Klein & Alexander Zlotnik

  2. Department of Anesthesiology, Yale University School of Medicine, New Haven, CT, 06525, USA

    Benjamin F. Gruenbaum & Shaun E. Gruenbaum

  3. Department of Anesthesiology and Oncology, National Research Center for Oncology and Transplantation, Astana, Kazakhstan

    Agzam Zhumadilov

  4. Department of Emergent Medicine, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Vladimir Zeldetz

Authors
  1. Evgeni Brotfain
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  2. Ruslan Kutz
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  3. Julia Grinshpun
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  4. Benjamin F. Gruenbaum
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  5. Shaun E. Gruenbaum
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  6. Amit Frenkel
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  7. Agzam Zhumadilov
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  8. Vladimir Zeldetz
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  9. Yoav Bichovsky
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  10. Matthew Boyko
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  11. Moti Klein
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  12. Alexander Zlotnik
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Corresponding author

Correspondence to Alexander Zlotnik.

Ethics declarations

This experiment was conducted according to the recommendations set forth by the Helsinki Committee and was approved by the Ethics Committee at Soroka University Medical Center, Beer Sheva, Israel.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Brotfain, E., Kutz, R., Grinshpun, J. et al. Blood Glutamate Reducing Effect of Hemofiltration in Critically Ill Patients. Neurotox Res 33, 300–308 (2018). https://doi.org/10.1007/s12640-017-9791-0

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  • DOI: https://doi.org/10.1007/s12640-017-9791-0

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