Pulmonary glutamine production: effects of sepsis and pulmonary infiltrates.
OBJECTIVE
To define the role of the lung in the production of glutamine in the critically ill and to determine the effects of the presence of pulmonary infiltrates and the presence and severity of sepsis.


METHODS
Prospective clinical study in a single center; interdisciplinary intensive care unit at a university hospital.


METHODS
Eleven critically ill patients were compared to ten patients prior to cardiac bypass surgery.


RESULTS
Fluxes of glutamine and other amino acids were measured. Chest radiography was performed, and APACHE II and multiple-organ failure scores were calculated. Septic patients showed significantly higher glutamine efflux from the lungs than controls. At least one-half of this glutamine is estimated to result from protein breakdown. Severity of illness had no impact on glutamine fluxes. In the presence of pulmonary infiltrates on chest radiographs glutamine efflux did not differ from zero.


CONCLUSIONS
The lungs produce significant amounts of glutamine in septic patients. Pulmonary infiltrates decrease the glutamine efflux from the lung in septic patients. We suggest that this is caused by uptake of glutamine by white cells in the lung exerting immunological functions.
Hulsewé
Karel W E
KW
Department of Surgery, Academic Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. k.hulsewe@ah.unimaas.nl
van der Hulst
René R W J
RR
Ramsay
Graham
G
van Berlo
Charles L H
CL
Deutz
Nicolaas E P
NE
Soeters
Peter B
PB
D000328:Adult; D000368:Aged; D005260:Female; D005973:Glutamine / Q000096:biosynthesis*; D006801:Humans; D008168:Lung / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018805:Sepsis / Q000378:metabolism*
D005973:Glutamine