The contribution of glutamine to citrulline and arginine synthesis, when alanyl-glutamine is supplied in an enteral dose of 0.5 g/kg, in critically ill patients.

Recruiting

Conditions: ernstig zieke IC patienten
amino acid metabolism in the critically ill patient

Registration Number: NL-OMON33557

Lead Sponsor: Vrije Universiteit Medisch Centrum

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Recruiting

Sex: Not specified

Target Recruitment: 20

Inclusion Criteria

*Age: > 18 and < 80 years
*BMI > 18,5 and < 35
*Ability to tolerate enteral nutrition, provided by postpyloric tube, meeting full protein/energy requirements based on indirect calorimetric measurements
*Expected ICU or medium care stay of a minimum of 5 days
*Any ICU patient who is considered *stable*:
* Hemodynamics: no new vasoactive medication during 24 hrs preceding inclusion, maximum dose of vasoactive medication < 5 mg/kg/min
* Respiration: PaO2/FiO2 ratio > 200, PEEP < 15 cm H2O, when on respiration
*Having obtained his/her or his/her legal representative*s informed consent

Exclusion Criteria

* Admission after elective surgery
* Pregnancy
* Liver failure, defined by bilirubin levels > 100
* Kidney failure, represented by increase in serum creatinine levels to > 100 umol/l, in the absence of primary underlying renal disease, or oliguria, defined as urine output < 20 ml/hour in the previous 6 weeks
* Urea cycle defects
* Chronic corticosteroids use ( > 7. mg/ day > 3 weeks)
* 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
* Parenteral feeding
* Use of medium chain triglycerides or glutamine/citrulline supplements

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>The whole body rate of appearance of glutamine, citrulline and arginine, as<br /><br>well as the conversion of endogenous and exogenous, enteral supplied glutamine<br /><br>into citrulline and arginine at the whole body level. </p><br>

Secondary Outcome Measures

Name	Time	Method
<p>First pass effect of the gut will be calculated using the difference between<br /><br>the whole body rate of appearance of glutamine when the glutamine tracer is<br /><br>given intravenously or enterally. </p><br>