- Poster presentation
- Open Access
Glutamine levels in patients with traumatic brain injury and subarachnoid haemorrhage
© van Rosmalen et al.; 2015
- Published: 1 October 2015
- Traumatic Brain Injury
- Severe Traumatic Brain Injury
- Glutamine Level
- Patient Data Management System
In critical illness, the rapid depletion of glutamine has been associated with increased mortality. This has led to the concept that early glutamine suppletion would benefit these patients.
A recent trial however showed that early suppletion of glutamine was associated with an increased mortality. In a majority of patients glutamine levels were within normal range at admission. Patients with severe traumatic brain injury (TBI) and subarachnoid haemorrhage (SAH) however, were excluded in this trial. In literature no data on glutamine levels are available in critically ill neurologic patients.
We conducted an observational pilot study measuring glutamine levels in the first week after TBI and acute SAH.
In a 30-bed intensive care unit of a teaching hospital patients admitted with TBI (n=5) and SAH (n=5) were selected. Plasma glutamine levels were measured at admission and on six consecutive days. Glutamine deficiency was defined as a plasma glutamine level of less than 420 µmol/L. Optimal nutrition per patient was calculated by a dietician. Jevity® standard, Plus and HiCal (Abbott Nutrition) were used containing 0.36-0.40 gram glutamine/100 kcal. Actual intake was noted in a Patient Data Management System (Metavision®, iMDsoft). Data were collected in Excel (Microsoft®) and analysed with SPSS® (IBM).
Glutamine <420 µmol/L
Glutamine >420 µmol/L
Age (median, years)
Gender (male/female, %)
Type of patient (SAH/TBI, %)
Mechanical ventilation (days)
Length Of Stay (days)
Hospital-Length Of Stay (days)
3-Month mortality (%)
We found low glutamine levels in 70% of TBI and SAH patients at admission but no evidence of glutamine depletion during treatment. Intake of only 72% of calculated optimal calorie intake and 71% of protein intake was sufficient to reach near-normal levels of glutamine in patients with TBI and SAH.
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