[Effect of glutamine depletion on immunity and other organ function in critically ill patients].
OBJECTIVE
To evaluate the effect of glutamine depletion on immunity and other organ function in critically ill patients.


METHODS
Ten healthy individuals served as control group. Forty seriously ill patients [acute pathological and chronic health evaluation II (APACHE II) score> or =8] admitted to the surgical critical care unit (SICU) were enrolled for study. Blood samples were collected at 6:00 am 48 hours after the admission for the determination of plasma glutamine (Gln), and parameters pertaining to immunity and organ functions.


RESULTS
The Gln levels in critically ill patients were significantly lower than that of control and negatively correlated with APACHE II score (r=-0.572, P<0.05). The CD4/CD8 ratio was positively correlated with the Gln level (r=0.704, P<0.05), while the monocyte HLA-DR expression lowered as compared to control. In patients with normal glutamine level, the incidence of abnormal total bilirubin >19 micromol/L, serum creatinine >110 micromol/L, and oxygenation index <300 mm Hg (1 mm Hg=0.133 kPa) was lower compared with those with low glutamine level (all P<0.05). In non-survivors Gln was significantly reduced to (333.2+/-95.1) micromol/L and it was significantly lower as compared to that of survivors (466.1+/-125.2) micromol/L (P<0.05).


CONCLUSIONS
In critically ill surgical patients glutamine depletion is evident, and the reduction in plasma Gln is related to immunosuppression and organ dysfunction.
Wang
Xin-ying
XY
Research Institute of General Surgery, Nanjing General Hospital of Nanjing Command, Nanjing 210002, Jiangsu, China. wxinying@263.net
Li
Wei-qin
WQ
Li
Ning
N
Li
Jie-shou
JS
D018806:APACHE; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood; D016516:CD4-CD8 Ratio; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D016638:Critical Illness; D005260:Female; D005973:Glutamine / Q000097:blood*; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D007109:Immunity; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism
D006684:HLA-DR Antigens; D005973:Glutamine; D003404:Creatinine; D001663:Bilirubin