Plasma glutamine depletion and patient outcome in acute ICU admissions

H. M. Oudemans-van Straaten, R. J. Bosman, M. Treskes, H. J.I. Van der Spoel, D. F. Zandstra

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: To evaluate whether low plasma glutamine (PG) is related to severity of illness, and actual and predicted hospital mortality. Design: Prospective cohort study. Setting: 18-bed closed format general intensive care unit (ICU) of a teaching hospital. Patients: Cohort of 80 seriously ill patients non-electively admitted to the ICU. Interventions: Blood sampling for the determination of PG at ICU admission. Measurements and results: Severity of illness and predicted mortality were calculated using the locally validated APACHE II, SAPS II, and MPM II 0 and 24 systems. Illness scores, and actual and predicted hospital mortality were compared between patients with total PG < 0.420 mmol/l ("low PG") and patients with PG≥0.420 mmol/l. Mean total PG was 0.523 mmol/l, range 0.220-1.780 mmol/l. Low PG (n = 25) was associated with higher age (P = 0.03), shock as primary diagnosis, and higher actual hospital mortality (60% vs 29%, P = 0.01). Normal to high PG was associated with high plasma creatine phosphokinase (P = 0.007). There was a nonsignificant trend towards higher severity of illness scores and predicted mortality rates in the low PG group. The presence of low PG significantly improved mortality prediction when added as a factor to the APACHE II predicted mortality rate (P = 0.02). Conclusions: Low PG at acute ICU admission is related to higher age, shock as primary diagnosis, and higher hospital mortality. Low PG represents a risk of poor outcome, not fully reflected in the presently used mortality prediction system.

Original languageEnglish
Pages (from-to)84-90
Number of pages7
JournalIntensive Care Medicine
Volume27
Issue number1
DOIs
Publication statusPublished - 24 Mar 2001

Cite this

@article{d534b35d246f48cba29c82daab5422cb,
title = "Plasma glutamine depletion and patient outcome in acute ICU admissions",
abstract = "Objective: To evaluate whether low plasma glutamine (PG) is related to severity of illness, and actual and predicted hospital mortality. Design: Prospective cohort study. Setting: 18-bed closed format general intensive care unit (ICU) of a teaching hospital. Patients: Cohort of 80 seriously ill patients non-electively admitted to the ICU. Interventions: Blood sampling for the determination of PG at ICU admission. Measurements and results: Severity of illness and predicted mortality were calculated using the locally validated APACHE II, SAPS II, and MPM II 0 and 24 systems. Illness scores, and actual and predicted hospital mortality were compared between patients with total PG < 0.420 mmol/l ({"}low PG{"}) and patients with PG≥0.420 mmol/l. Mean total PG was 0.523 mmol/l, range 0.220-1.780 mmol/l. Low PG (n = 25) was associated with higher age (P = 0.03), shock as primary diagnosis, and higher actual hospital mortality (60{\%} vs 29{\%}, P = 0.01). Normal to high PG was associated with high plasma creatine phosphokinase (P = 0.007). There was a nonsignificant trend towards higher severity of illness scores and predicted mortality rates in the low PG group. The presence of low PG significantly improved mortality prediction when added as a factor to the APACHE II predicted mortality rate (P = 0.02). Conclusions: Low PG at acute ICU admission is related to higher age, shock as primary diagnosis, and higher hospital mortality. Low PG represents a risk of poor outcome, not fully reflected in the presently used mortality prediction system.",
keywords = "Glutamine, Intensive care, Nutrition, Outcome, Patient outcome assessment, Severity of illness index",
author = "{Oudemans-van Straaten}, {H. M.} and Bosman, {R. J.} and M. Treskes and {Van der Spoel}, {H. J.I.} and Zandstra, {D. F.}",
year = "2001",
month = "3",
day = "24",
doi = "10.1007/s001340000703",
language = "English",
volume = "27",
pages = "84--90",
journal = "Intensive Care Medicine",
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Plasma glutamine depletion and patient outcome in acute ICU admissions. / Oudemans-van Straaten, H. M.; Bosman, R. J.; Treskes, M.; Van der Spoel, H. J.I.; Zandstra, D. F.

In: Intensive Care Medicine, Vol. 27, No. 1, 24.03.2001, p. 84-90.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Plasma glutamine depletion and patient outcome in acute ICU admissions

AU - Oudemans-van Straaten, H. M.

AU - Bosman, R. J.

AU - Treskes, M.

AU - Van der Spoel, H. J.I.

AU - Zandstra, D. F.

PY - 2001/3/24

Y1 - 2001/3/24

N2 - Objective: To evaluate whether low plasma glutamine (PG) is related to severity of illness, and actual and predicted hospital mortality. Design: Prospective cohort study. Setting: 18-bed closed format general intensive care unit (ICU) of a teaching hospital. Patients: Cohort of 80 seriously ill patients non-electively admitted to the ICU. Interventions: Blood sampling for the determination of PG at ICU admission. Measurements and results: Severity of illness and predicted mortality were calculated using the locally validated APACHE II, SAPS II, and MPM II 0 and 24 systems. Illness scores, and actual and predicted hospital mortality were compared between patients with total PG < 0.420 mmol/l ("low PG") and patients with PG≥0.420 mmol/l. Mean total PG was 0.523 mmol/l, range 0.220-1.780 mmol/l. Low PG (n = 25) was associated with higher age (P = 0.03), shock as primary diagnosis, and higher actual hospital mortality (60% vs 29%, P = 0.01). Normal to high PG was associated with high plasma creatine phosphokinase (P = 0.007). There was a nonsignificant trend towards higher severity of illness scores and predicted mortality rates in the low PG group. The presence of low PG significantly improved mortality prediction when added as a factor to the APACHE II predicted mortality rate (P = 0.02). Conclusions: Low PG at acute ICU admission is related to higher age, shock as primary diagnosis, and higher hospital mortality. Low PG represents a risk of poor outcome, not fully reflected in the presently used mortality prediction system.

AB - Objective: To evaluate whether low plasma glutamine (PG) is related to severity of illness, and actual and predicted hospital mortality. Design: Prospective cohort study. Setting: 18-bed closed format general intensive care unit (ICU) of a teaching hospital. Patients: Cohort of 80 seriously ill patients non-electively admitted to the ICU. Interventions: Blood sampling for the determination of PG at ICU admission. Measurements and results: Severity of illness and predicted mortality were calculated using the locally validated APACHE II, SAPS II, and MPM II 0 and 24 systems. Illness scores, and actual and predicted hospital mortality were compared between patients with total PG < 0.420 mmol/l ("low PG") and patients with PG≥0.420 mmol/l. Mean total PG was 0.523 mmol/l, range 0.220-1.780 mmol/l. Low PG (n = 25) was associated with higher age (P = 0.03), shock as primary diagnosis, and higher actual hospital mortality (60% vs 29%, P = 0.01). Normal to high PG was associated with high plasma creatine phosphokinase (P = 0.007). There was a nonsignificant trend towards higher severity of illness scores and predicted mortality rates in the low PG group. The presence of low PG significantly improved mortality prediction when added as a factor to the APACHE II predicted mortality rate (P = 0.02). Conclusions: Low PG at acute ICU admission is related to higher age, shock as primary diagnosis, and higher hospital mortality. Low PG represents a risk of poor outcome, not fully reflected in the presently used mortality prediction system.

KW - Glutamine

KW - Intensive care

KW - Nutrition

KW - Outcome

KW - Patient outcome assessment

KW - Severity of illness index

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U2 - 10.1007/s001340000703

DO - 10.1007/s001340000703

M3 - Article

VL - 27

SP - 84

EP - 90

JO - Intensive Care Medicine

JF - Intensive Care Medicine

SN - 0342-4642

IS - 1

ER -