Glutamine supplementation fails to affect muscle protein kinetics in critically ill patients

Dennis Gore, Robert R. Wolfe, Salloum

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background: In vitro work suggests that glutamine availability may be an important factor in controlling the rate of muscle protein synthesis. The objective of this study was to determine if enteral administration of glutamine affects muscle protein metabolism in critically ill patients. Methods: Six postsurgical patients requiring prolonged mechanical ventilation for pneumonia (age, 51 ± 12 years, Acute Physiology and Chronic Health Evaluation [APACHE] 22 ± 6, mean ± SEM) and 6 normal healthy volunteers (age, 33 ± 4 years) underwent evaluation of whole body and muscle protein metabolism using an 8-hour infusion of d5-phenylalanine, 515N glutamine, and d3-alanine with serial blood sampling from the femoral artery and vein and biopsies from the vastus lateralis muscle. Metabolic measurements were obtained while subjects received Peptamen enterally (Basal Period) and with glutamine supplementation (24 g/3 h; Glutamine Period). Results: Glutamine concentration in muscle was significantly less in the critically ill patients. Glutamine supplementation increased the arterial plasma concentration of glutamine, yet with no demonstratable effect on muscle glutamine concentration or on the rate of muscle protein synthesis in either volunteers or patients. Furthermore, muscle glutamine kinetics (incorporation into muscle, release from muscle, and rate of de novo glutamine synthesis in muscle) were not affected by glutamine supplementation in the critically ill patients. In contrast, there was a significant decrease in these kinetic parameters with glutamine supplementation within the muscle of healthy subjects. Metabolism of alanine was unaffected by administration of glutamine in either group. Conclusions: Enteral glutamine supplementation to critically ill patients fails to alter muscle glutamine metabolism or muscle protein synthesis. This suggests a possible restriction in transport of glutamine into muscle of critically ill patients.

Original languageEnglish (US)
Pages (from-to)342-350
Number of pages9
JournalJournal of Parenteral and Enteral Nutrition
Volume26
Issue number6
StatePublished - Nov 2002

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Muscle Proteins
muscle protein
Glutamine
Critical Illness
glutamine
kinetics
Muscles
muscles
Healthy Volunteers
protein synthesis
protein metabolism
Alanine
alanine
Small Intestine
volunteers
APACHE
metabolism
Femoral Vein
blood sampling
body protein

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Glutamine supplementation fails to affect muscle protein kinetics in critically ill patients. / Gore, Dennis; Wolfe, Robert R.; Salloum.

In: Journal of Parenteral and Enteral Nutrition, Vol. 26, No. 6, 11.2002, p. 342-350.

Research output: Contribution to journalArticle

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