Whole body protein turnover in critically ill patients with multiple organ failure. Issue 1 (February 2015)

• Record Type: Journal Article
• Authors: Rooyackers, Olav; Kouchek-Zadeh, Ramin; Tjäder, Inga; Norberg, Åke; Klaude, Maria; Wernerman, Jan
• Is Part Of: Clinical nutrition. Volume 34:Issue 1(2015:Feb.)
• Page Start: 95
• Page End: 100
• Publication Date: 2015-02
• Subjects: Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2014.01.020
• Languages: English
• ISSNs: 0261-5614

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background & aims</title> <p id="abspara0010">To evaluate the effect of nutrition therapy on protein turnover in critically ill patients isotopically labeled amino acids can be used. Here parallel measurements using <sup>13</sup>C-leucine and <sup>2</sup>H<sub>5</sub>-phenylalanine were performed to evaluate if one tracer was to be preferred.</p> </sec> <sec> <title id="sectitle0020">Methods</title> <p id="abspara0015">As a reference group, healthy volunteers (<italic>n</italic> = 8) were studied in the postabsorptive state and during parenteral nutrition delivery. ICU patients with multiple organ failure (<italic>n</italic> = 8) were studied during parenteral nutrition delivery only.</p> </sec> <sec> <title id="sectitle0025">Results</title> <p id="abspara0020">For the volunteers, the net protein balances changed from negative to positive during parenteral nutrition delivery (compared to the postabsorptive state) when evaluated with leucine and phenylalanine (<italic>P</italic> < 0.0001). For phenylalanine this change was attributable to an increased protein synthesis (<italic>P</italic> < 0.0001), while for leucine the change was attributable to a decreased protein degradation (<italic>P</italic> < 0.0001). For the patients, only measured during parenteral nutrition delivery, the estimates by the two amino acid tracers agreed, showing a protein balance not statistically significantly different from zero. The whole body protein turnover was higher than that of the healthy volunteers during parenteral nutrition delivery. In the patients, the net protein balance correlated positively to the amount of amino acids given.</p> </sec> <sec> <title id="sectitle0030">Conclusions</title> <p id="abspara0025">Critically ill patients with multiple organ failure have an increased protein turnover. The findings in the healthy volunteers indicate that the use of the two different amino acid tracers in parallel in future studies should be considered.</p> </sec> </abstract>