Exudative glutamine losses contribute to high needs after burn injury.

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Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_27300263B67D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Exudative glutamine losses contribute to high needs after burn injury.
Journal
JPEN. Journal of parenteral and enteral nutrition
Author(s)
Berger M.M., Binz P.A., Roux C., Charrière M., Scaletta C., Raffoul W., Applegate L.A., Pantet O.
ISSN
1941-2444 (Electronic)
ISSN-L
0148-6071
Publication state
Published
Issued date
05/2022
Peer-reviewed
Oui
Volume
46
Number
4
Pages
782-788
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Burnpatients characteristically have increased energy, glucose, and protein requirements. Glutamine supplementation is strongly recommended during early-phase treatment and is associated with improved immunity, wound healing, and reduced mortality. This study evaluated if early burn exudative losses might contribute to higher supplementation needs.
Patients admitted to the burn intensive care unit (ICU) had exudate collection from tight bandages applied to arms or legs during the first week (exudate aliquot twice daily). Seven amino acids (alanine, arginine, cystEine, glutamine, leucine, lysine, and methionine) were quantified by liquid chromatography-mass spectrometry. Descriptive analysis of all results is provided as median and interquartile range or in value ranges.
Eleven patients aged 19-77 years, presenting with burns on 18%-70% of the body surface, with a median simplified acute physiology score II of 33 (range, 16-56) were included during the study period. The highest amino acid losses were observed during the first 3 days with an important interpatient and intrapatient variability. Glutamine and alanine losses were highest, followed by leucine and lysine in all patients; amino acid exudate concentrations were in the range of normal plasma concentrations and were stable over time. Total glutamine losses were correlated to the burned surface (r <sup>2</sup> = 0.552, P = .012), but not to enteral glutamine supplements.
The study shows significant exudative losses during early-stage burn recovery and particularly for glutamine and alanine. Glutamine loss generally decreased with wound closure, the subsequent decline of exudation, and the evolving size of burn surfaces.
Keywords
Alanine, Arginine, Glutamine, Humans, Leucine, Lysine, amino acid, metabolism, nutrition, protein, wound healing
Pubmed
Web of science
Open Access
Yes
Create date
26/07/2021 8:25
Last modification date
23/11/2022 7:09
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