Study of Glutamate and Glutamine Metabolism in Burn Patients Receiving Enteral or Parenteral Nutrition
| Status: | Withdrawn |
|---|---|
| Conditions: | Other Indications, Hospital |
| Therapuetic Areas: | Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/14/2017 |
| Start Date: | November 2009 |
| End Date: | October 2010 |
The purpose of the study is to understand how the body uses amino acids in burned patients
during the time they cannot eat normally. Amino acids occur naturally in the body and the
food we eat. The body combines amino acids to make protein. It uses the proteins to do
things such as heal wounds, fight infection, and provide energy. We are studying two ways of
receiving nutrition: through a vein or through a tube. We are also studying two different
types of food: with or without glutamine. The results of this study will be used to
determine the best type and way to supply nutrients during a severe burn injury. We hope to
learn how to help the body use nutrients more efficiently to better repair wounded tissues
and recover earlier from injury.
during the time they cannot eat normally. Amino acids occur naturally in the body and the
food we eat. The body combines amino acids to make protein. It uses the proteins to do
things such as heal wounds, fight infection, and provide energy. We are studying two ways of
receiving nutrition: through a vein or through a tube. We are also studying two different
types of food: with or without glutamine. The results of this study will be used to
determine the best type and way to supply nutrients during a severe burn injury. We hope to
learn how to help the body use nutrients more efficiently to better repair wounded tissues
and recover earlier from injury.
We hypothesize that:
1. Burn patients will experience an increased conversion of glutamine to glutamate and a
decreased conversion of glutamate to glutamine as compared to healthy subjects. The net
direction is from glutamine to glutamate in burn patients and would render glutamine as
a conditionally essential amino acid.
2. Because of the limited ability of liver to oxidize glutamate, it is possible that large
doses of glutamine may cause increased gluconeogenesis in burn patients, thus
aggravating the glucose homeostasis secondary to insulin resistance.
3. Enterally and parenterally fed glutamine and glutamate have different metabolic fate in
the splanchnic bed and peripheral regions, therefore the doses should be tailored
according to the route of administration.
This study, using stable isotope tracers, aims to track the metabolic fate of glutamine and
glutamate in body with the goal of enhancing nutritional efficiency.
1. Burn patients will experience an increased conversion of glutamine to glutamate and a
decreased conversion of glutamate to glutamine as compared to healthy subjects. The net
direction is from glutamine to glutamate in burn patients and would render glutamine as
a conditionally essential amino acid.
2. Because of the limited ability of liver to oxidize glutamate, it is possible that large
doses of glutamine may cause increased gluconeogenesis in burn patients, thus
aggravating the glucose homeostasis secondary to insulin resistance.
3. Enterally and parenterally fed glutamine and glutamate have different metabolic fate in
the splanchnic bed and peripheral regions, therefore the doses should be tailored
according to the route of administration.
This study, using stable isotope tracers, aims to track the metabolic fate of glutamine and
glutamate in body with the goal of enhancing nutritional efficiency.
Inclusion Criteria:
- One or more of the following:
- 5% Total Body Surface Area Thermal Burn
- Inhalation Injury
- Resting Energy Expenditure of >15% of the predicted Basal Metabolic Rate Using
Harris-Benedict.
- Receiving Enteral or Parental Nutritional Support
Exclusion Criteria:
- Pre-existing:
- Thyroid disease
- Congestive Heart Failure (Ejection fraction <20%)
- Malignancy currently under treatment
- Medical conditions requiring glucocorticoid treatment
- Decision not to treat because of severity of injury
- Presence of Anoxic brain injury with no expectation for recovery
- Self-Inflicted thermal injury
- Ileus, gut paralysis, or facial injuries
- No NG or OG tube as part of their clinical care
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