title: Plasma glutamine concentration after intensive care unit discharge: an observational study.
abstract: BACKGROUND
  Low plasma glutamine concentration at ICU admission is associated with unfavorable outcomes. The prediction of plasma glutamine concentration after ICU discharge on outcomes has not been characterized. In the recent Scandinavian Glutamine Trial, a survival advantage was seen with glutamine supplementation as long as patients stayed in the ICU. It was therefore hypothesized that the glutamine level may drop at ICU discharge, indicative of a sustained glutamine deficiency, which may be related to outcome.
  
  
  METHODS
  Fully fed ICU patients intravenously supplemented with glutamine for >3 days were studied at ICU discharge and post ICU. In study A, plasma glutamine level was followed every 5 to 7 days post ICU of the remaining hospital stay and compared to the level on the day of ICU discharge (n=63). In study B, plasma glutamine level 24 to 72 hours after ICU discharge was related to 12-month all-cause mortality (n=100).
  
  
  RESULTS
  Post-ICU plasma glutamine levels were within normal range and were not found to be predictive for mortality outcome. Plasma glutamine level at discharge, on the other hand, was within normal limits but higher in nonsurvivors. In addition, it was adding prediction value to discharge SOFA scores for post-ICU mortality.
  
  
  CONCLUSIONS
  Post-ICU glutamine levels are not indicative of glutamine depletion. The relation between plasma glutamine concentration and glutamine availability during critical illness is not well understood, and needs to be studied further to define the possible role for glutamine supplementation.
authors.forename: Marie
authors.initials: M
authors.lastname: Smedberg
authors.forename: Johanna Nordmark
authors.initials: JN
authors.lastname: Grass
authors.forename: Linn
authors.initials: L
authors.lastname: Pettersson
authors.forename: Åke
authors.initials: Å
authors.lastname: Norberg
authors.forename: Olav
authors.initials: O
authors.lastname: Rooyackers
authors.forename: Jan
authors.initials: J
authors.lastname: Wernerman
mesh_terms: D000368:Aged; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D005973:Glutamine / Q000097:blood* / Q000627:therapeutic use; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D063868:Patient Outcome Assessment; D016019:Survival Analysis
chemical_list: D005973:Glutamine