Prolonged continuous intravenous infusion of the dipeptide L-alanine- L-glutamine significantly increases plasma glutamine and alanine without elevating brain glutamate in patients with severe traumatic brain injury.

ABSTRACT: Low plasma glutamine levels are associated with worse clinical outcome. Intravenous glutamine infusion dose- dependently increases plasma glutamine levels, thereby correcting hypoglutaminemia. Glutamine may be transformed to glutamate which might limit its application at a higher dose in patients with severe traumatic brain injury (TBI). To date, the optimal glutamine dose required to normalize plasma glutamine levels without increasing plasma and cerebral glutamate has not yet been defined.Changes in plasma and cerebral glutamine, alanine, and glutamate as well as indirect signs of metabolic impairment reflected by increased intracranial pressure (ICP), lactate, lactate-to-pyruvate ratio, electroencephalogram (EEG) activity were determined before, during, and after continuous intravenous infusion of 0.75 g L-alanine-L-glutamine which was given either for 24 hours (group 1, n?=?6) or 5 days (group 2, n?=?6) in addition to regular enteral nutrition. Lab values including nitrogen balance, urea and ammonia were determined daily.Continuous L-alanine-L-glutamine infusion significantly increased plasma and cerebral glutamine as well as alanine levels, being mostly sustained during the 5 day infusion phase (plasma glutamine: from 295?±?62 to 500?±?145 ?mol/ l; brain glutamine: from 183?±?188 to 549?±?120 ?mol/ l; plasma alanine: from 327?±?91 to 622?±?182 ?mol/ l; brain alanine: from 48?±?55 to 89?±?129 ?mol/ l; p?

SUBMITTER: Nageli M 

PROVIDER: S-EPMC4227121 | biostudies-literature | 2014 Jul

REPOSITORIES: biostudies-literature