title: Plasma Glutamine Concentrations in Liver Failure.
abstract: BACKGROUND
  Higher than normal plasma glutamine concentration at admission to an intensive care unit is associated with an unfavorable outcome. Very high plasma glutamine levels are sometimes seen in both acute and chronic liver failure. We aimed to systematically explore the relation between different types of liver failure and plasma glutamine concentrations.
  
  
  METHODS
  Four different groups of patients were studies; chronic liver failure (n = 40), acute on chronic liver failure (n = 20), acute fulminant liver failure (n = 20), and post-hepatectomy liver failure (n = 20). Child-Pugh and Model for End-stage Liver Disease (MELD) scores were assessed as indices of liver function. All groups except the chronic liver failure group were followed longitudinally during hospitalisation. Outcomes were recorded up to 48 months after study inclusion.
  
  
  RESULTS
  All groups had individuals with very high plasma glutamine concentrations. In the total group of patients (n = 100), severity of liver failure correlated significantly with plasma glutamine concentration, but the correlation was not strong.
  
  
  CONCLUSIONS
  Liver failure, regardless of severity and course of illness, may be associated with a high plasma glutamine concentration. Further studies are needed to understand whether high glutamine levels should be regarded as a biomarker or as a contributor to symptomatology in liver failure.
authors.affiliation: Department of Anesthesia & Intensive Care, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Gunnel
authors.initials: G
authors.lastname: Helling
authors.affiliation: Department of gastroenterology and hepatology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Staffan
authors.initials: S
authors.lastname: Wahlin
authors.affiliation: Department of Anesthesia & Intensive Care, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Smedberg
authors.affiliation: Department of Anesthesia & Intensive Care, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Linn
authors.initials: L
authors.lastname: Pettersson
authors.affiliation: Department of Anesthesia & Intensive Care, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Inga
authors.initials: I
authors.lastname: Tjäder
authors.affiliation: Department of Anesthesia & Intensive Care, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Åke
authors.initials: Å
authors.lastname: Norberg
authors.affiliation: Department of Anesthesia & Intensive Care, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Olav
authors.initials: O
authors.lastname: Rooyackers
authors.affiliation: Department of Anesthesia & Intensive Care, Karolinska University Hospital Huddinge and Karolinska Institutet, Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Wernerman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D058625:End Stage Liver Disease / Q000097:blood*; D005260:Female; D005973:Glutamine / Q000009:adverse effects / Q000097:blood* / Q000737:chemistry; D006498:Hepatectomy; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D017114:Liver Failure, Acute / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005973:Glutamine