title: Both high and low plasma glutamine levels predict mortality in critically ill patients.
abstract: OBJECTIVE
  Plasma amino acids are important indicators for understanding human kinetics and amino acid dynamics. We aimed to investigate the association between the plasma glutamine levels and the mortality rates and determine whether plasma glutamine can predict the prognosis of critically ill patients.
  
  
  METHODS
  The clinical records of adult patients who were admitted to an ICU were retrospectively evaluated to investigate the plasma levels of amino acids, including glutamine.
  
  
  RESULTS
  Two hundred fourteen patients were included in this study (male, 62%; median age, 64 years; range 20-97 years). The patients' diagnoses included sepsis (45%), trauma (14%), cardiovascular disease (9%), fulminant hepatitis (9%), burns (4%), and others (19%). The mortality rates in patients with plasma glutamine <400 nmol/mL (group L; 39%, 28/71) or ≥700 nmol/mL (group H; 50%, 15/30) were significantly higher (p < 0.05 and p < 0.01, respectively) than those in patients with plasma glutamine levels of 400-700 nmol/mL (group M; 21%, 24/113). Among patients with sepsis, the mortality rates of group L (46%) and group H (67%) were significantly higher (p < 0.05 or p < 0.01, respectively) in comparison with group M (26%).
  
  
  CONCLUSIONS
  Both lower and higher plasma glutamine levels were risk factors for mortality in critically ill patients.
authors.affiliation: Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin University, 1-1-3 Minatojima, Chuo-ku, Kobe, Hyogo, Japan. ttsujimoto@pharm.kobegakuin.ac.jp.|Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka, Japan. ttsujimoto@pharm.kobegakuin.ac.jp.
authors.forename: Takae
authors.initials: T
authors.lastname: Tsujimoto
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Nutrition Support Service, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Hata
authors.affiliation: Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Graduate School of Pharmaceutical Sciences, Osaka University, 1-6 Yamadaoka, Suita, Osaka, Japan.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Uejima
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogura
authors.affiliation: Nutrition Support Service, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Wasa
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimazu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002056:Burns / Q000401:mortality; D002318:Cardiovascular Diseases / Q000401:mortality; D016638:Critical Illness / Q000401:mortality*; D005260:Female; D005973:Glutamine / Q000097:blood*; D006505:Hepatitis / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000401:mortality; D014947:Wounds and Injuries / Q000401:mortality; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005973:Glutamine
keywords: Amino acid; Critically ill patients; Glutamine; Mortality; Stress