ICU, intensive care critically ill patients, ernstig zieke patiënten glutamine citrulline arginine alanyl-glutamine metabolic route, metabole route enteral nutrition, enterale voeding
Conditions
Interventions
1. Group 1 (control group): 10 patients will receive enteral tube feeding, containing 1.5 g/kg protein/day ( including 0.15 g/kg/day glutamine ) for at least 5 days
2. Group 2 (treatment group): 10 patients will receive enteral tube feeding for 5 days + 0.5 g/24hr L-alanyl-L-glutamine containing 1.5 g/kg protein (including 0.475 g/kg/day glutamine ).
Each gro
Sponsors
VU University medical Center
Eligibility
Inclusion criteria
Inclusion criteria: 1. Age: > 18; 2. BMI >18,5 and 200, PEEP < 15 cm H2O; 8. Having obtained his/her or his/her legal representative’s informed consent. For group 3: 1. Requiring CVVH; 2. No endstage kidney disease (defined by need for dialysis for longer than 3 months); 3. No persistent acute renal failure (loss) (defined as need for renal replacement therapy for more than 4 weeks).
Exclusion criteria
Exclusion criteria: 1. Planned admission for recovery after elective surgery; 2. Pregnancy; 3. Liver failure, defined by bilirubin levels > 100 µmol/L; 4. Hyperammonaemia; 5. Kidney failure, represented by increase in serum creatinine levels to > 150 umol/l, in the absence of primary underlying renal disease, or oliguria, defined as urine output 7.5 mg/ day > 3 weeks); 8. Proven bowel malabsorption possibly interfering with intestinal absorptive function, e.g. celiac disease, crohn’s disease, presence of fistulas, major intestinal malabsorption disorder, or short bowel syndrome; 9. Parenteral feeding; 10. Use of medium chain triglycerides or glutamine/citrulline supplements.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The whole body rate of appearance of glutamine, citrulline and arginine, as well as the conversion of endogenous and exogenous, enterally supplied glutamine into citrulline and arginine at the whole body level. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. First pass effect of the gut will be calculated using the difference between the whole body rate of appearance of the amino acids when the tracers are given intravenously or enterally; 2. Renal amino acid metabolism will be calculated by comparing the tracer whole body rate of appearance of the amino acids in a group with normal kidney function and a group with ARF. | — |
Contacts
Public ContactA. Beishuizen
VU Medical Center Department of Intensive Care P.O. Box 7057
Outcome results
None listed