Document Detail


Pharmacologically dosed oral glutamine reduces myocardial injury in patients undergoing cardiac surgery: a randomized pilot feasibility trial.
MedLine Citation:
PMID:  22623413     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Glutamine (GLN) has been shown to protect against in vitro and in vivo myocardial injury. In humans, perioperative ischemia/reperfusion (I/R) injury during cardiac surgery is associated with higher morbidity and mortality. The objective of this safety and feasibility pilot trial was to determine if pharmacologically dosed, preoperative oral GLN attenuates myocardial injury in cardiac surgery patients.
METHODS: Patients undergoing elective cardiac surgery, requiring cardiopulmonary bypass, were enrolled in a randomized, double-blind pilot trial to receive 25 g twice of oral alanyl-glutamine (GLN; n = 7) or maltodextrin (CONT; n = 7) daily for 3 days preoperatively. Serum troponin (TROP I), creatine kinase (CK-MB), and myoglobin (MG) were measured at multiple perioperative time points. Clinical outcomes were also recorded and assessed.
RESULTS: GLN therapy significantly decreased TROP I levels at 24, 48, and 72 hours postoperatively (all P < .05) vs CONT. GLN also reduced CK-MB at 24 and 48 hours (P < .05, P < .001) vs CONT. MG was reduced at 24 hours vs control (P = .0397). GLN also significantly reduced pooled clinical complications vs CONT (P = .03).
CONCLUSION: This pilot study showed that pharmacologically dosed oral GLN therapy prior to cardiac surgery was safe, well tolerated, and feasible. GLN therapy reduced myocardial injury and clinical complications in this small randomized, blinded feasibility trial. These data indicate that a larger trial of preoperative GLN therapy in patients undergoing cardiac surgery is needed to confirm clinical benefit.
Authors:
Alexandra Sufit; Lindsay B Weitzel; Christine Hamiel; Kelly Queensland; Ira Dauber; Olav Rooyackers; Paul E Wischmeyer
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2012-05-23
Journal Detail:
Title:  JPEN. Journal of parenteral and enteral nutrition     Volume:  36     ISSN:  0148-6071     ISO Abbreviation:  JPEN J Parenter Enteral Nutr     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-17     Completed Date:  2013-01-03     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  7804134     Medline TA:  JPEN J Parenter Enteral Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  556-61     Citation Subset:  IM    
Affiliation:
University of Colorado School of Medicine, Aurora, Colorado, USA.
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Cardiac Surgical Procedures* / adverse effects
Cardiopulmonary Bypass* / methods
Creatine Kinase / blood
Dipeptides / administration & dosage
Dose-Response Relationship, Drug*
Double-Blind Method
Feasibility Studies
Female
Glutamine / administration & dosage*,  blood
HSP70 Heat-Shock Proteins / genetics,  metabolism
Humans
Male
Middle Aged
Myocardial Reperfusion Injury / prevention & control*
Myoglobin / blood
Pilot Projects
Polysaccharides / administration & dosage
Treatment Outcome
Troponin / blood
Grant Support
ID/Acronym/Agency:
K23 RR018379/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Dipeptides; 0/HSP70 Heat-Shock Proteins; 0/Myoglobin; 0/Polysaccharides; 0/Troponin; 56-85-9/Glutamine; 9050-36-6/maltodextrin; EC 2.7.3.2/Creatine Kinase; U5JDO2770Z/alanylglutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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