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Preoperative glutamine loading does not prevent endotoxemia in cardiac surgery
R Suojaranta-Ylinen1, E Ruokonen, K Pulkki
1Department of Intensive Care, Kuopio University Hospital, Finland.
Acta Anaesthesiologica Scandinavica
|March 1, 1997
Summary
Glutamine supplementation did not prevent endotoxemia or alter tumor necrosis factor (TNF) levels in cardiac surgery patients. Endotoxemia also did not impact hemodynamics or metabolism post-surgery.
Area of Science:
- Cardiology
- Critical Care Medicine
- Surgical Nutrition
Background:
- Endotoxemia is common in cardiac surgery patients, potentially worsening metabolic and hemodynamic responses.
- Impaired gut metabolism can lead to bacterial translocation and endotoxemia.
- Glutamine may offer protection to the gut mucosal barrier during low perfusion states.
Purpose of the Study:
- To investigate the impact of glutamine supplementation on endotoxemia and tumor necrosis factor (TNF) levels during and after cardiac surgery.
- To assess how endotoxemia affects systemic and regional hemodynamics and metabolism post-cardiac surgery.
Main Methods:
- A randomized controlled trial involving 19 coronary bypass patients.
- Patients received either a glucose/amino acid solution or alanyl-glutamine preoperatively.
- Measurements included endotoxemia, TNF levels, and hemodynamic/metabolic parameters.
Main Results:
- Glutamine loading did not prevent peri- or postoperative endotoxemia.
- Elevated TNF levels were frequent, occurring in some patients without endotoxemia.
- Endotoxemia did not significantly alter systemic or regional hemodynamics and metabolism.
Conclusions:
- Glutamine supplementation failed to prevent endotoxemia in cardiac surgery patients.
- Elevated TNF is common, irrespective of endotoxemia.
- Endotoxemia did not influence metabolic or hemodynamic outcomes in this study population.