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Plasma Amino Acids as Predictors for Outcome in Patients at the Intense Care Unit
Author(s) -
Twelkmeyer Brigitte,
Rodas Paul Castillo,
SkogNejman Eva,
Wernerman Jan,
Rooyackers Olav
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.1073.6
Subject(s) - amino acid , phenylalanine , medicine , norvaline , intensive care unit , wasting , gastroenterology , arginine , chemistry , valine , biochemistry
Amino acids (AA) are important metabolites in blood plasma. In critically ill patients muscle wasting and successive organ failure affect recovery and are one of the most common causes of death in the intense care unit (ICU). Disturbances in the plasma metabolites such as AA could report on complications and act as predictor for outcome. Here, we present the analysis of 22 amino acids concentrations in plasma of successively admitted critically ill patients (N= 174) in the ICU at the Karolinska University Hospital Huddinge [1]. The admission scoring of APACHE II, SOFA and the mortality up to 6 months were registered. Arterial blood samples were taken within 24 hours after admission and analysed by HPLC with pre‐column derivatization and an internal standard of norvaline [2]. Patients were grouped into six‐months survivors and non‐survivors. Statistical analysis of AA concentrations was accomplished using R, version 2.15.1. A Wilcoxon rank sum test showed that phenylalanine (p= 0.03), alanine (p=0.03), tyrosine (p= 0.002), 3‐methylhistidine (p=0.006), carnitine (p=0.03) and ornithine (p= 0.08) were differed between the two groups with higher plasma concentrations in patients that died. The plasma concentrations of branched chain amino acids were not significantly different. Three patients showed highly elevated concentrations of two AA (Ala, Gln) possibly indicating a subgroup of patients with specific clinical characteristics such as single organ failure. In conclusion, those patients that died showed higher plasma concentration of several AA. Some of the amino acids (Phe, Tyr, 3‐methylhistidine) may represent a negative protein turnover i.e. increased muscle protein loss. This work was supported by a grant from the Swedish Research Council and Karolinska University Hospital Huddinge.