Trial reportNutrition (Burbank, Los Angeles County, Calif.)2008
Depletion of plasma antioxidants in surgical intensive care unit patients requiring parenteral feeding: effects of parenteral nutrition with or without alanyl-glutamine dipeptide supplementation.
Trial report in Nutrition (Burbank, Los Angeles County, Calif.), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Vitamin C in Critically Ill Patients: An Updated Systematic Review and Meta-Analysis.Nutrients · 2021Pooled it
- What is the evidence for the use of parenteral nutrition (PN) in critically ill surgical patients: a systematic review and meta-analysis.Techniques in coloproctology · 2018Pooled it
- Effect of coenzyme Q10 supplementation on oxidative stress and clinical outcomes in patients with low levels of coenzyme Q10 admitted to the intensive care unit.Journal of nutritional science · 2021Trial
- Article
- High-Dose Intravenous Ascorbic Acid: Ready for Prime Time in Traumatic Brain Injury?Neurocritical care · 2020Article
- Intravenous vitamin C in the supportive care of cancer patients: a review and rational approach.Current oncology (Toronto, Ont.) · 2018Review
- Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities.Nutrients · 2017Review
- The gastrointestinal immune system: Implications for the surgical patient.Current problems in surgery · 2016Review
- Glutamine and glutathione at ICU admission in relation to outcome.Clinical science (London, England : 1979) · 2012Article
- Antioxidants and micronutrient supplementation in trauma patients.Current opinion in clinical nutrition and metabolic care · 2012Review
- Preoperative short-term parenteral administration of polyunsaturated fatty acids ameliorates intestinal inflammation and postoperative ileus in rodents.Langenbeck's archives of surgery · 2012Article
- Amino acid composition in parenteral nutrition: what is the evidence?Current opinion in clinical nutrition and metabolic care · 2011Review
- Congestive heart failure: where homeostasis begets dyshomeostasis.Journal of cardiovascular pharmacology · 2010Article
- Acetaminophen has limited antipyretic activity in critically ill patients.Journal of critical care · 2010Article
- Uncoupling the coupled calcium and zinc dyshomeostasis in cardiac myocytes and mitochondria seen in aldosteronism.Journal of cardiovascular pharmacology · 2010Article
- Ascorbate protects endothelial barrier function during septic insult: Role of protein phosphatase type 2A.Free radical biology & medicine · 2010Article
- Parenteral nutrition in the critically ill patient.The New England journal of medicine · 2009Review
- Individual variation in macronutrient regulation measured by proton magnetic resonance spectroscopy of human plasma.American journal of physiology. Regulatory, integrative and comparative physiology · 2009Article
- Mechanism of action of vitamin C in sepsis: ascorbate modulates redox signaling in endothelium.BioFactors (Oxford, England)Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesAntioxidant depletion is common in critically ill patients. This study was designed to determine the effects of parenteral nutrition (PN), with or without glutamine (Gln) supplementation, on systemic antioxidant status in adult patients after major surgery who required PN in the surgical intensive care unit (SICU) setting.
methodsFifty-nine patients in the SICU who required PN after pancreatic surgery or cardiac, vascular, or colonic (non-pancreatic) surgery were randomized in a double-blinded study to receive standard PN (Gln-free) or Gln-supplemented PN (Gln-PN) in which Gln was provided as alanyl-Gln dipeptide. Conventional PN vitamin and mineral doses were administered to all subjects. Plasma concentrations of the antioxidant glutathione (GSH) and the antioxidant nutrients alpha-tocopherol, vitamin C, and zinc were determined at baseline (initiation of study PN) and again after 7 d of study PN. Data were analyzed for the total study cohort and within the pancreatic surgery and non-pancreatic (cardiac, vascular, and colonic) surgery patient subgroups.
resultsMean plasma antioxidant concentrations were within or slightly below the normal ranges at baseline. However, a larger percentage of patients demonstrated below-normal baseline plasma concentrations of GSH (59%), vitamin C (59%), and zinc (68%), respectively. A smaller percentage of patients exhibited below-normal plasma alpha-tocopherol levels (21%). Study PN significantly improved plasma zinc levels in the entire study group and in each surgical subgroup. Gln-PN significantly improved the change in plasma levels of reduced GSH from baseline to day 7 in the non-pancreatic surgery patients (PN -0.27 microM versus Gln-PN +0.26 microM, P < 0.03).
conclusionLow plasma levels of key antioxidants were common in this group of patients in the SICU despite administration of PN containing conventional micronutrients. Compared with standard PN, Gln-supplemented PN improved plasma GSH levels in patients in the SICU after cardiac, vascular, or colonic operations.
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