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Prevalence of glutamine deficiency in ICU patients: a cross-sectional analytical study.

ABSTRACT: Not only is glutamine deficiency an independent predictor of mortality in intensive care unit (ICU) patients, but glutamine supplementation is also recommended for its proven outcome benefits. However, recent data suggest that early glutamine supplementation in certain patient groups increase mortality. The aim of this study was to investigate plasma glutamine levels of adult ICU patients in the South African setting and to determine relationships between glutamine levels, gender, diagnostic categories and selected inflammatory markers. The data from this study will be used as baseline measurement to support a large scale study that will be undertaken in the South African ICU population.This cross-sectional, analytical study included 60 mixed adult ICU patients within 24 h post ICU admission. Plasma glutamine levels were determined on admission. The relationship between glutamine levels, Interleukin-6 (IL-6) and C-reactive protein (CRP); as well as gender- and diagnosis-related differences in glutamine levels were also investigated. A non-parametric ROC curve was computed to determine the CRP concentration cut-off point above which glutamine becomes deficient.The median plasma glutamine level (497 μmol/L) was in the normal range; however, 38.3 % (n = 23) of patients had deficient (<420 μmol/L) and 6.7 % (n = 4) had supra-normal glutamine levels (>930 μmol/L). No significant difference could be detected between glutamine levels and gender or diagnosis categories as a group. When only the medical and surgical categories were compared, the median plasma glutamine level of the medical patients were significantly lower than that of the surgical patients (p = 0.042). Glutamine showed inverse associations with CRP levels (r = -0.44, p < 0.05) and IL-6 concentrations (r = -0.23, p = 0.08). A CRP cut-off value of 95.5 mg/L was determined above which glutamine levels became deficient.About a third of patients (38 %) were glutamine deficient on admission to ICU, whereas some presented with supra-normal levels. While glutamine levels correlated inversely with inflammatory markers, and a CRP value of above 95.5 mg/L indicated potential glutamine deficiency, the clinical application of this finding needs further investigation.

SUBMITTER: Nienaber A

PROVIDER: S-EPMC4969685 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Project description:Anaemia during pregnancy is still 1 of the leading causes of maternal and neonatal mortality in low and middle-income countries. Initiatives to address this need evidence on trends and their relevant factors, as they vary from 1 area to another. This study determined the prevalence of anemia and its associated factors among pregnant women in Ilala, Tanzania. This community-based, analytical cross-sectional study was conducted in April 2022 involving 367 randomly selected pregnant women. An interviewer-administered questionnaire and a HemoCue analyzer were used for data collection The data was described using descriptive statistics (frequency distributions, percentages, etc) and inferential statistics (Chi-square tests and logistic regression) were used to explore the associations between the study's outcome and its explanatory variables, with a significance level of P < .05. The mean age of participants was 26.2 (standard deviation = 5.2) years, 58.0% had a secondary education level, and 45.2 were prime-para. About half (57.2%) of all participants had low hemoglobin level, among which, 36.2% had moderate anemia. Having a primary education level (adjusted odds ratio [AOR] = 2.3, confidence interval [CI] = 1.1-4.7), having an inter-pregnancy interval of <18 months (AOR = 2.6, CI = 1.2-5.5), being in the third trimester (AOR = 2.4, CI = 1.2-4.7), not taking Intermittent Prophylaxis Treatment (AOR = 3.7, CI = 1.3-10), not taking iron supplement and folic acid (AOR = 3.7, CI = 1.3-10), and having a moderate appetite(AOR = 1.6, CI = 1.0-2.6) were predictors of anemia. Nutritionally related factors were not consuming on a daily basis dairy food (AOR = 3.7, CI = 1.4-9.3), meat/fish (AOR = 6.6, CI = 3-14), dark green and other vegetables (AOR = 6.6, CI = 3.1-14), fruits (AOR = 4.2, CI = 1.4-12) and having a lower dietary diversity score (AOR = 84, CI = 37-188). Approximately half of pregnant women in Ilala municipality were anemic with 1 third of them having moderate anemia. The associated factors varied from nutritional, obstetric, and socio-demographic factors. The targeted interventions should focus on health promotion campaign to sensitize the population on the dangers of anemia in pregnancy and preventive measures that must be adhered to.

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Prevalence of glutamine deficiency in ICU patients: a cross-sectional analytical study.

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