Depletion of plasma antioxidants in surgical intensive care unit patients requiring parenteral feeding: effects of parenteral nutrition with or without alanyl-glutamine dipeptide supplementation

被引：53

作者：

Luo, Menghua ^{[1
]}

Fernandez-Estivariz, Concepcion ^{[1
]}

Jones, Dean P. ^{[1
,3
]}

Accardi, Carolyn R. ^{[1
]}

Alteheld, Birgit ^{[1
]}

Bazargan, Niloofar ^{[1
]}

Hao, Li ^{[1
]}

Griffith, Daniel P. ^{[5
]}

Blumberg, Jeffrey B. ^{[4
]}

Galloway, John R. ^{[2
,5
]}

Ziegler, Thomas R. ^{[1
,3
,5
]}

机构：

[1] Emory Univ, Sch Med, Dept Med, Atlanta, GA 30332 USA

[2] Emory Univ, Sch Med, Dept Surg, Atlanta, GA 30322 USA

[3] Emory Univ, Sch Med, Ctr Clin & Mol Nutr, Atlanta, GA USA

[4] Tufts Univ, USDA, Jean Mayer Human Nutr Res Ctr Aging, Boston, MA 02111 USA

[5] Emory Univ Hosp, Nutr & Metab Support Serv, Atlanta, GA 30322 USA

来源：

NUTRITION | 2008年 / 24卷 / 01期

关键词：

alpha-tocopherol; critical illness; glutathione; parenteral nutrition; vitamin C; zinc;

D O I：

10.1016/j.nut.2007.10.004

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

Objectives: Antioxidant depletion is common in critically ill patients. This study was designed to determine the effects of parenteral nutrition (PN), with or without glutamine (Gln) supplementation, on systemic antioxidant status in adult patients after major surgery who required PN in the surgical intensive care unit (SICU) setting. Methods: Fifty-nine patients in the SICU who required PN after pancreatic surgery or cardiac, vascular, or colonic (non-pancreatic) surgery were randomized in a double-blinded study to receive standard PN (Gln-free) or Gln-supplemented PN (Gln-PN) in which Gln was provided as alanyl-Gin dipeptide. Conventional PN vitamin and mineral doses were administered to all subjects. Plasma concentrations of the antioxidant glutathione (GSH) and. the antioxidant nutrients alpha-tocopherol, vitamin C, and zinc were determined at baseline (initiation of study PN) and again after 7 d of study PN. Data were analyzed for the total study cohort and within the pancreatic surgery and non-pancreatic (cardiac, vascular, and colonic) surgery patient subgroups. Results: Mean plasma antioxidant concentrations were within or slightly below the normal ranges. at baseline. However, a larger percentage of patients demonstrated below-normal baseline plasma concentrations of GSH (59%), vitamin C (59%), and zinc (68%), respectively. A smaller percentage of patients exhibited below-normal plasma a-tocopherol levels (21%). Study PN significantly improved plasma zinc levels in the entire study group and in each surgical subgroup, Gln-PN significantly improved the change in plasma levels of reduced GSH from baseline to day 7 in the non-pancreatic surgery patients (PN -0.27 mu M versus Gln-PN +0.26 mu M, P < 0.03). Conclusion: Low plasma levels of key antioxidants were common in this group of patients in the SICU despite administration of PN containing conventional micronutrients. Compared with standard PN, Gln-supplemented PN improved plasma GSH levels in patients in the SICU after cardiac, vascular, or colonic operations. (C) 2008 Elsevier Inc. All rights reserved.

引用

页码：37 / 44

页数：8

共 37 条

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