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Taurine Concentrations Decrease in Critically Ill Patients With Shock Given Enteral Nutrition.
JPEN J Parenter Enteral Nutr 2016; 40(2):264-72JJ

Abstract

BACKGROUND

Nutrition studies in the intensive care unit (ICU) have shown that adequate enteral nutrition (EN) support has clinical benefits. However, the course of amino acid concentrations in plasma has never been investigated in patients admitted with shock receiving EN. We hypothesized that plasma concentrations, when deficit, increase during EN and that persistent deficiency is associated with poor outcome.

METHODS

In 33 septic or cardiogenic shock patients receiving EN, plasma amino acid concentrations were measured during 5 days. Changes in amino acid concentrations, correlations with clinical outcome variables, and regression analyses were studied.

RESULTS

On ICU admission, several plasma concentrations were deficient. Plasma concentrations of almost all amino acids increased. In contrast, taurine decreased by >50%, from 47.6 µmol/L on admission to 20.0 µmol/L at day 1, and remained low at day 5. Taurine (admission) correlated with time on mechanical ventilation (R = -0.42, P = .015). Taurine decrease within 24 hours correlated with Acute Physiology and Chronic Health Evaluation II predicted mortality (R = 0.43, P = .017) and Sequential Organ Failure Assessment score (R = 0.36, P = .05). Regression analyses confirmed correlations.

CONCLUSIONS

Several amino acids were deficient in plasma on ICU admission but increased during EN. Taurine concentrations declined and were associated with longer periods of mechanical ventilation and ICU support. Fast taurine decline correlated with severity of organ failure. These findings support the role of taurine during ischemia, reperfusion, and inflammation. Taurine may be an essential candidate to enrich nutrition support for critically ill patients, although more research is required.

Authors+Show Affiliations

Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.Department of Anesthesiology, Academic Medical Center, Amsterdam, The Netherlands.Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands Department of Cardio-thoracic Surgery, Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands.Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.Department of Surgery, Medical Center Alkmaar, Alkmaar, The Netherlands.Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.Intensive Care Unit, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands Intensive Care Unit, VU University Medical Center, Amsterdam, The Netherlands h.oudemans@vumc.nl.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25587009

Citation

Vermeulen, Mechteld A R., et al. "Taurine Concentrations Decrease in Critically Ill Patients With Shock Given Enteral Nutrition." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 40, no. 2, 2016, pp. 264-72.
Vermeulen MA, van Stijn MF, Visser M, et al. Taurine Concentrations Decrease in Critically Ill Patients With Shock Given Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2016;40(2):264-72.
Vermeulen, M. A., van Stijn, M. F., Visser, M., Lemmens, S. M., Houdijk, A. P., van Leeuwen, P. A., & Oudemans-van Straaten, H. M. (2016). Taurine Concentrations Decrease in Critically Ill Patients With Shock Given Enteral Nutrition. JPEN. Journal of Parenteral and Enteral Nutrition, 40(2), pp. 264-72. doi:10.1177/0148607114567199.
Vermeulen MA, et al. Taurine Concentrations Decrease in Critically Ill Patients With Shock Given Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2016;40(2):264-72. PubMed PMID: 25587009.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Taurine Concentrations Decrease in Critically Ill Patients With Shock Given Enteral Nutrition. AU - Vermeulen,Mechteld A R, AU - van Stijn,Mireille F M, AU - Visser,Marlieke, AU - Lemmens,Stéphanie M P, AU - Houdijk,Alexander P J, AU - van Leeuwen,Paul A M, AU - Oudemans-van Straaten,Heleen M, Y1 - 2015/01/13/ PY - 2014/05/26/received PY - 2014/12/01/accepted PY - 2015/1/15/entrez PY - 2015/1/15/pubmed PY - 2016/12/15/medline KW - ICU KW - amino acids KW - arginine KW - cardiogenic shock KW - glutamine KW - protein KW - sepsis SP - 264 EP - 72 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 40 IS - 2 N2 - BACKGROUND: Nutrition studies in the intensive care unit (ICU) have shown that adequate enteral nutrition (EN) support has clinical benefits. However, the course of amino acid concentrations in plasma has never been investigated in patients admitted with shock receiving EN. We hypothesized that plasma concentrations, when deficit, increase during EN and that persistent deficiency is associated with poor outcome. METHODS: In 33 septic or cardiogenic shock patients receiving EN, plasma amino acid concentrations were measured during 5 days. Changes in amino acid concentrations, correlations with clinical outcome variables, and regression analyses were studied. RESULTS: On ICU admission, several plasma concentrations were deficient. Plasma concentrations of almost all amino acids increased. In contrast, taurine decreased by >50%, from 47.6 µmol/L on admission to 20.0 µmol/L at day 1, and remained low at day 5. Taurine (admission) correlated with time on mechanical ventilation (R = -0.42, P = .015). Taurine decrease within 24 hours correlated with Acute Physiology and Chronic Health Evaluation II predicted mortality (R = 0.43, P = .017) and Sequential Organ Failure Assessment score (R = 0.36, P = .05). Regression analyses confirmed correlations. CONCLUSIONS: Several amino acids were deficient in plasma on ICU admission but increased during EN. Taurine concentrations declined and were associated with longer periods of mechanical ventilation and ICU support. Fast taurine decline correlated with severity of organ failure. These findings support the role of taurine during ischemia, reperfusion, and inflammation. Taurine may be an essential candidate to enrich nutrition support for critically ill patients, although more research is required. SN - 1941-2444 UR - https://www.unboundmedicine.com/medline/citation/25587009/Taurine_Concentrations_Decrease_in_Critically_Ill_Patients_With_Shock_Given_Enteral_Nutrition_ L2 - https://doi.org/10.1177/0148607114567199 DB - PRIME DP - Unbound Medicine ER -