Table 1.
Changes in enteral nutrition, neuromonitoring, caloric requirement, and laboratory values before, during, and after prolonged continuous L-alanine-L-glutamine infusion
| Before infusion | During infusion | After infusion | |
|---|---|---|---|
|
Enteral nutrition and L-alanine-L-glutamine infusion | |||
| Enteral nutrition (ml/h) |
42 ± 8, 30, 62 |
45 ± 11, 25, 60 |
47 ± 15, 30, 90 |
| Calories (kcal/d) |
1512 ± 288, 1,080, 2,232 |
1620 ± 396, 900, 2,160 |
1692 ± 540, 1,080, 3,240 |
| L-alanine-L-glutamine (ml/h) |
-- |
13 ± 2, 9, 15 |
-- |
|
Neuromonitoring | |||
| ICP (mmHg) |
11 ± 4, 4, 18 |
9 ± 5, 0, 40 |
9 ± 6, 0, 25 |
| CPP (mmHg) |
78 ± 6, 71, 90 |
79 ± 7, 60, 98 |
80 ± 8, 56, 110 |
| Brain temperature (°C) |
35.1 ± 0.2, 34.8, 35.4 |
35.4 ± 0.26, 34.6, 36 |
35.5 ± 0.5, 34.5, 37 |
| ptiO2 (mmHg) |
23 ± 11, 10, 40 |
29 ± 9, 15, 65 |
27 ± 8, 11, 57 |
| BIS |
33 ± 8, 20, 45 |
35 ± 12, 10, 94 |
42 ± 18, 10, 89* |
| Brain glucose (mM) |
0.76 ± 0.99; 0.5, 3.5 |
1.1 ± 1.1; 0.6, 4.6 |
0.68 ± 1.0; 0.4, 6,5 |
| Brain lactate (mM) |
2.2 ± 3.5; 0.8, 11 |
3.8 ± 1.6; 0.5, 8.5 |
3.2 ± 1.7; 0.5, 9.3 |
| Brain lactate-to-pyruvate ratio |
14 ± 25; 2.4, 88 |
14 ± 23; 2, 136 |
9 ± 22; 3, 300 |
|
Caloric requirement | |||
| Kcal |
1,830 ± 193; 1,440, 1,940 |
1,945 ± 320; 1,480, 2,810 |
2,115 ± 353; 1,830, 2,830* |
| RQ |
0.84 ± 0.07; 0.76, 0.94 |
0.84 ± 0.05; 0.76, 0.96 |
0.83 ± 0.07;0.72, 0.9 |
|
Laboratory values | |||
| CRP |
149 ± 79, 1.3, 203 |
109 ± 78; 25, 371 |
76 ± 69; 12, 269 |
| Fibrinogen |
4 ± 1.7; 1.7, 7.1 |
6.2 ± 1.5; 2.3, 8.5 |
6.5 ± 1.8; 2.2, 11.6 |
| Albumin (g/L) |
23 ± 4; 13, 29 |
22 ± 4; 14, 31 |
21 ± 5; 14, 33 |
| Blood urea (mmol/L) |
2.7 ± 1.6; 1.2, 7 |
5.5 ± 1.5; 1.6, 9.7* |
5.1 ± 2.2; 2.2, 10.5 |
| Ammonia (μmol/L) |
12 ± 6.3; 6, 25 |
26 ± 8.3; 10, 51* |
26 ± 8.4; 4, 34* |
| Creatinine (μmol/L) |
68 ± 23; 53, 126 |
66 ± 16; 42, 122 |
68 ± 17; 45, 99 |
| GOT (U/ml) |
44 ± 61, 15, 206 |
42 ± 40; 13, 165 |
60 ± 53; 13, 191 |
| GPT (U/ml) |
20 ± 50; 11, 141 |
19 ± 64, 10, 172 |
18 ± 58, 12, 158 |
| Urine urea (mmol/L) |
74 ± 56; 40, 203 |
136 ± 85; 31, 398 |
117 ± 53; 36, 215 |
| Nitrogen balance (g/d) |
8 ± 3.6; 5.9, 10.7 |
10 ± 1.6; 6.9, 11 |
8.5 ± 3.3; 6, 16.5 |
| Lymphocytes (10-3/μl) |
0.9 ± 0.4; 0.37, 1.58 |
0.9 ± 0.3; 0.38, 1.59 |
1.0 ± 0.7; 0.72, 3.17 |
|
Sedation | |||
| Midazolam (mg/h) | 90 ± 20; 60, 110 | 90 ± 20; 60, 110 | 70 ± 20; 40, 90* |
Nitrogen balance was calculated based on administered nitrogen from protein and amino acids minus nitrogen in urinary urea without including other potential losses via, for example, skin and stool. Results are shown as median ± standard deviation; range. *P <0.001 analysis of variance and post hoc Dunn’s test. ICP, CPP, BIS, ptiO2, RQ, respiratory quotient; CRP, C-reactive protein; GOT, aspartate aminotransferase; GPT, alanine aminotransferase.