Skip to main content
Top
Published in: Intensive Care Medicine 12/2003

01-12-2003 | Original

Temporal changes in muscle glutathione in ICU patients

Authors: U. B. Fläring, O. E. Rooyackers, J. Wernerman, F. Hammarqvist

Published in: Intensive Care Medicine | Issue 12/2003

Login to get access

Abstract

Objective

This study investigated the changes over time in glutathione and its constituent amino acids in skeletal muscle of ICU patients with multiple organ failure.

Design and setting

Prospective and descriptive pilot study in two medium-sized ICUs with ten beds.

Patients

Critically ill patients (n=10) with multiple organ failure and with an expected ICU stay longer than 6 days were included during their initial 3 days after admission to the ICU.

Measurements and results

Muscle biopsy and blood samples were taken on days 0, 3, and 6 after inclusion and total, reduced, and oxidized glutathione and the related amino acids were determined. During the study period both total and reduced glutathione increased and was in the normal range on day 6. The constituent amino acids normalized during the study period as well.

Conclusions

This pilot study demonstrates a recovery of muscle glutathione concentrations in critically ill patients with ongoing multiple organ failure within 1 week. Restoration of muscle glutathione seems to be a biological process of high priority in this group of patients.
Literature
1.
go back to reference Keller GA, Barke R, Harty JT, Humphrey E, Simmons RL (1985) Decreased hepatic glutathione levels in septic shock. Arch Surg 120:941–945CrossRef Keller GA, Barke R, Harty JT, Humphrey E, Simmons RL (1985) Decreased hepatic glutathione levels in septic shock. Arch Surg 120:941–945CrossRef
2.
go back to reference Leff J, Parsons P, Day C, Moore F, Repine J (1993) Serum antioxidants as predictors of adult respiratory distress syndrome in patients with sepsis. Lancet 341:777–780CrossRef Leff J, Parsons P, Day C, Moore F, Repine J (1993) Serum antioxidants as predictors of adult respiratory distress syndrome in patients with sepsis. Lancet 341:777–780CrossRef
3.
go back to reference Pacht ER, Timerman AP, Lykens MG, Merola AJ (1991) Deficiency of alveolar fluid glutathione in patients with sepsis and the adult respiratory distress syndrome. Chest 100:1397–1403CrossRef Pacht ER, Timerman AP, Lykens MG, Merola AJ (1991) Deficiency of alveolar fluid glutathione in patients with sepsis and the adult respiratory distress syndrome. Chest 100:1397–1403CrossRef
4.
go back to reference Metnitz GH, Fischer M, Bartens C, Steltzer H, Lang T, Druml W (2000) Impact of acute renal failure on antioxidant status in multiple organ failure. Acta Anaesthesiol Scand 44:236–240CrossRef Metnitz GH, Fischer M, Bartens C, Steltzer H, Lang T, Druml W (2000) Impact of acute renal failure on antioxidant status in multiple organ failure. Acta Anaesthesiol Scand 44:236–240CrossRef
5.
go back to reference Taylor DE, Piantadosi CA (1995) Oxidative metabolism in sepsis and sepsis syndrome. J Crit Care 10:122–135CrossRef Taylor DE, Piantadosi CA (1995) Oxidative metabolism in sepsis and sepsis syndrome. J Crit Care 10:122–135CrossRef
6.
go back to reference Beutler E (1989) Nutritional and metabolic aspects of glutathione. Annu Rev Nutr 9:287–302CrossRef Beutler E (1989) Nutritional and metabolic aspects of glutathione. Annu Rev Nutr 9:287–302CrossRef
7.
go back to reference Meister A (1991) Glutathione deficiency produced by inhibitors of its synthesis and its reversal: applications in research and therapy. Pharmacol Ther 51:155–194CrossRef Meister A (1991) Glutathione deficiency produced by inhibitors of its synthesis and its reversal: applications in research and therapy. Pharmacol Ther 51:155–194CrossRef
8.
go back to reference Tischler ME, Fagan JM (1982) Relationship of the reduction-oxidation state to protein degradation in skeletal and atrial muscle. Arch Biochem Biophys 217:191–201CrossRef Tischler ME, Fagan JM (1982) Relationship of the reduction-oxidation state to protein degradation in skeletal and atrial muscle. Arch Biochem Biophys 217:191–201CrossRef
9.
go back to reference Hammarqvist F, Luo J-L, Andersson K, Wernerman J (1997) Skeletal muscle glutathione is depleted in critically ill patients. Crit Care Med 25:78–84CrossRef Hammarqvist F, Luo J-L, Andersson K, Wernerman J (1997) Skeletal muscle glutathione is depleted in critically ill patients. Crit Care Med 25:78–84CrossRef
10.
go back to reference Corbucci GG, Gasparetto A, Candiani A, Crimi G, Antonelli M, Bufi M, De Blasi RA, Cooper MB, Gohil K (1985) Shock-induced damage to mitochondrial function and some cellular antioxidant mechanisms in humans. Circ Shock 15:15–26PubMed Corbucci GG, Gasparetto A, Candiani A, Crimi G, Antonelli M, Bufi M, De Blasi RA, Cooper MB, Gohil K (1985) Shock-induced damage to mitochondrial function and some cellular antioxidant mechanisms in humans. Circ Shock 15:15–26PubMed
11.
go back to reference Brealey D, Brand M, Hargreaves I, Heales S, Land J, Smolenski R, Davies NA, Cooper CE, Singer M (2002) Association between mitochondrial dysfunction and severity and outcome of septic shock. Lancet 360:219–223CrossRef Brealey D, Brand M, Hargreaves I, Heales S, Land J, Smolenski R, Davies NA, Cooper CE, Singer M (2002) Association between mitochondrial dysfunction and severity and outcome of septic shock. Lancet 360:219–223CrossRef
12.
go back to reference Wilmore DW, Preston R, Muhlbacher F (1983) Injured man: Trauma and sepsis. In: Winters RW, Green HL (eds) Nutritional support of the seriously ill patients. Academic, London, pp 33–52 Wilmore DW, Preston R, Muhlbacher F (1983) Injured man: Trauma and sepsis. In: Winters RW, Green HL (eds) Nutritional support of the seriously ill patients. Academic, London, pp 33–52
13.
go back to reference Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13:818–829CrossRef Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13:818–829CrossRef
14.
go back to reference Vincent J-L, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med 22:707–710CrossRef Vincent J-L, Moreno R, Takala J, Willatts S, De Mendonca A, Bruining H, Reinhart CK, Suter PM, Thijs LG (1996) The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intensive Care Med 22:707–710CrossRef
15.
go back to reference Le Gall JR, Leneshow S, Saulnier F (1993) A New Simplified Acute Physiology Score (SAPS 2) Based on a European/North American multicenter study. JAMA 270:2957–2963CrossRef Le Gall JR, Leneshow S, Saulnier F (1993) A New Simplified Acute Physiology Score (SAPS 2) Based on a European/North American multicenter study. JAMA 270:2957–2963CrossRef
16.
go back to reference Bergström J (1962) Muscle electrolytes in man. Scand J Clin Lab Invest. 168:11–14 Bergström J (1962) Muscle electrolytes in man. Scand J Clin Lab Invest. 168:11–14
17.
go back to reference Fläring UB, Rooyackers OE, Hammarqvist F, Wernerman J (2003) Glutamine attenuates post-traumatic glutathione depletion in human muscle. Clin Sci (Colch) 104:275–282 Fläring UB, Rooyackers OE, Hammarqvist F, Wernerman J (2003) Glutamine attenuates post-traumatic glutathione depletion in human muscle. Clin Sci (Colch) 104:275–282
18.
go back to reference Hammarqvist F, Luo J-L, Andersson K, Wernerman J (1995) Glutathione and amino acid concentrations in ICU-patients. JPEN J Parenter Enteral Nutr 19:19S Hammarqvist F, Luo J-L, Andersson K, Wernerman J (1995) Glutathione and amino acid concentrations in ICU-patients. JPEN J Parenter Enteral Nutr 19:19S
19.
go back to reference Luo J-L, Hammarqvist F, Andersson K, Wernerman J (1996) Skeletal muscle glutathione after surgical trauma. Ann Surg 223:420–427CrossRef Luo J-L, Hammarqvist F, Andersson K, Wernerman J (1996) Skeletal muscle glutathione after surgical trauma. Ann Surg 223:420–427CrossRef
20.
go back to reference Wennström I, Wernerman J, Hammarqvist F (1999) Postoperative effects of growth hormone and insulin-like growth factor-1 on the nitrogen balance and muscle amino acid pattern. Clin Nutr 18 [Suppl 1]:14 Wennström I, Wernerman J, Hammarqvist F (1999) Postoperative effects of growth hormone and insulin-like growth factor-1 on the nitrogen balance and muscle amino acid pattern. Clin Nutr 18 [Suppl 1]:14
21.
go back to reference Westman B, Hammarqvist F, Johansson G, Luo J-L, Söderlund K, Wernerman J (1999) Effects of ischaemia and reperfusion on glutathione and energy content in skeletal muscle during elective surgery of abdominal aortic aneurysm. Clin Nutr 18 [Suppl 1]:2 Westman B, Hammarqvist F, Johansson G, Luo J-L, Söderlund K, Wernerman J (1999) Effects of ischaemia and reperfusion on glutathione and energy content in skeletal muscle during elective surgery of abdominal aortic aneurysm. Clin Nutr 18 [Suppl 1]:2
22.
go back to reference Meister A (1988) Glutathione metabolism and its selective modification. J Biol Chem 25:17205–17208CrossRef Meister A (1988) Glutathione metabolism and its selective modification. J Biol Chem 25:17205–17208CrossRef
23.
go back to reference Vesali RF, Klaude M, Rooyackers OE, Tjäder I, Barle H, Wernerman J (2002) Longitudinal pattern of glutamine/glutamate balance across the leg in long-stay intensive care unit patients. Clin Nutr 21:505–514CrossRef Vesali RF, Klaude M, Rooyackers OE, Tjäder I, Barle H, Wernerman J (2002) Longitudinal pattern of glutamine/glutamate balance across the leg in long-stay intensive care unit patients. Clin Nutr 21:505–514CrossRef
24.
go back to reference Gamrin L, Essén P, Hultman E, Wernerman J (1996) A descriptive study of skeletal muscle metabolism in critically ill patients: free amino acids, energy rich phosphates, protein, nucleic acids, fat, water and electrolytes. Crit Care Med 24:575–583CrossRef Gamrin L, Essén P, Hultman E, Wernerman J (1996) A descriptive study of skeletal muscle metabolism in critically ill patients: free amino acids, energy rich phosphates, protein, nucleic acids, fat, water and electrolytes. Crit Care Med 24:575–583CrossRef
25.
go back to reference Pettilä V, Pettilä M, Sarna S, Voutilainen P, Takkunen O (2002) Comparison of multiple organ dysfunction scores in the prediction of hospital mortality in the critically ill. Crit Care Med 30:1705–1711CrossRef Pettilä V, Pettilä M, Sarna S, Voutilainen P, Takkunen O (2002) Comparison of multiple organ dysfunction scores in the prediction of hospital mortality in the critically ill. Crit Care Med 30:1705–1711CrossRef
26.
go back to reference Kvåle R, Flaaten H (2002) Changes in intensive care from 1987 to 1997—has outcome improved? A single centre study. Intensive Care Med 28:1110–1116CrossRef Kvåle R, Flaaten H (2002) Changes in intensive care from 1987 to 1997—has outcome improved? A single centre study. Intensive Care Med 28:1110–1116CrossRef
Metadata
Title
Temporal changes in muscle glutathione in ICU patients
Authors
U. B. Fläring
O. E. Rooyackers
J. Wernerman
F. Hammarqvist
Publication date
01-12-2003
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 12/2003
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-003-2031-5

Other articles of this Issue 12/2003

Intensive Care Medicine 12/2003 Go to the issue