Evidence map›Paper›PMID 30981628›Full record

Trial reportClinical nutrition (Edinburgh, Scotland)2020

Role of heat shock protein and cytokine expression as markers of clinical outcomes with glutamine-supplemented parenteral nutrition in surgical ICU patients.

Paul E Wischmeyer, Rachael A Mintz-Cole, Christine H Baird, Kirk A Easley, Addison K May, Harry C Sax, Kenneth A Kudsk, Li Hao, Phong H Tran, Dean P Jones and 2 more

Open access · greenAbstract readClinical Trial, Phase IIIMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical nutrition (Edinburgh, Scotland), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Glutamine amelioratesThe journal of venomous animals and toxins including tropical diseases · 2023
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 1 country.

Paul E WischmeyerDuke University Hospital, Department of Anesthesiology and Duke Clinical Research Institute, 2301 Erwin Rd, Durham, NC 27710, USA. Electronic address: Paul.wischmeyer@duke.edu.
Rachael A Mintz-ColeDuke University Hospital, Department of Anesthesiology and Duke Clinical Research Institute, 2301 Erwin Rd, Durham, NC 27710, USA. Electronic address: rachael.mintzcole@gmail.com.
Christine H BairdUniversity of Colorado Denver Anschutz Medical Campus, Anesthesiology, 12700 E. 19th Avenue Box 8602, Aurora, CO 80045, USA. Electronic address: Christine.baird@ucdenver.edu.
Kirk A EasleyDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. Electronic address: keasle2@emory.edu.
Addison K MayDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN 37240, USA. Electronic address: Addison.may@vanderbilt.edu.
Harry C SaxDepartment of Surgery, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA. Electronic address: SaxH@cshs.org.
Kenneth A KudskDepartment of Surgery, University of Wisconsin, Schools of Medicine and Public Health, Madison, Madison, WI 53792, USA. Electronic address: kudsk@surgery.wisc.edu.
Li HaoDivision of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA. Electronic address: lhao2@emory.edu.
Phong H TranDivision of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA. Electronic address: phong.tran@emory.edu.
Dean P JonesDivision of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA; Center for Clinical and Molecular Nutrition, Emory University School of Medicine, Atlanta, GA 30322, USA. Electronic address: Dpjones@emory.edu.
Henry M BlumbergDivision of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA. Electronic address: hblumbe@emory.edu.
Thomas R ZieglerDivision of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA; Center for Clinical and Molecular Nutrition, Emory University School of Medicine, Atlanta, GA 30322, USA; Atlanta Veterans Affairs Medical Center, Decatur, GA 30033, USA. Electronic address: tzieg01@emory.edu.
Emory University · USCedars-Sinai Medical Center · USClinical Research Institute · USDuke University Hospital · USUniversity of Colorado Denver · USUniversity of Wisconsin–Madison · USVanderbilt University Medical Center · USVeterans Health Administration · US

Funding

Atlanta Clinical and Translational Science Institute (ACTSI) RenewalUL1TR000454 · NCATS · EMORY UNIVERSITY · PI STEPHENS, DAVID S · 2012 to 2016
$25.8M
Efficacy and Mechanisms of GLN Dipeptide in the SICUU01DK069322 · NIDDK · EMORY UNIVERSITY · PI ZIEGLER, THOMAS R · 2005 to 2012
$4.0M
Mechanism of Heat Shock Protein Induction by GlutamineR01GM078312 · NIGMS · UNIVERSITY OF COLORADO DENVER · PI WISCHMEYER, PAUL E · 2008 to 2012
$1.3M
Patient Oriented Research In Clinical NutritionK24DK096574 · NIDDK · EMORY UNIVERSITY · PI ZIEGLER, THOMAS R · 2012 to 2016
$888k
Mentored Patient-Oriented Research Career Development AwardK23RR018379 · NCRR · UNIVERSITY OF COLORADO DENVER · PI WISCHMEYER, PAUL E · 2003 to 2007
$653k
NCATS NIH HHS UL1 TR000454NCRR NIH HHS K23 RR018379NIDDK NIH HHS K24 DK096574NIDDK NIH HHS U01 DK069322NIGMS NIH HHS R01 GM078312
6 · The paper itself

Abstract

backgroundNutrients, such as glutamine (GLN), have been shown to effect levels of a family of protective proteins termed heat shock proteins (HSPs) in experimental and clinical critical illness. HSPs are believed to serve as extracellular inflammatory messengers and intracellular cytoprotective molecules. Extracellular HSP70 (eHSP70) has been termed a chaperokine due to ability to modulate the immune response. Altered levels of eHSP70 are associated with various disease states. Larger clinical trial data on GLN effect on eHSP expression and eHSP70's association with inflammatory mediators and clinical outcomes in critical illness are limited.

objectiveExplore effect of longitudinal change in serum eHSP70, eHSP27 and inflammatory cytokine levels on clinical outcomes such as pneumonia and mortality in adult surgical intensive care unit (SICU) patients. Further, evaluate effect of parenteral nutrition (PN) supplemented with GLN (GLN-PN) versus GLN-free, standard PN (STD-PN) on serum eHSP70 and eHSP27 concentrations.

methodsSecondary observational analysis of a multicenter clinical trial in 150 adults after cardiac, vascular, or gastrointestinal surgery requiring PN support and SICU care conducted at five academic medical centers. Patients received isocaloric, isonitrogenous PN, with or without GLN dipeptide. Serum eHSP70 and eHSP27, interleukin-6 (IL-6), and 8 (IL-8) concentrations were analyzed in patient serum at baseline (prior to study PN) and over 28 days of follow up.

resultseHSP70 declined over time in survivors during 28 days follow-up, but non-survivors had significantly higher eHSP70 concentrations compared to survivors. In patients developing pneumonia, eHSP70, eHSP27, IL-8, and IL-6 were significantly elevated. Adjusted relative risk for hospital mortality was reduced 75% (RR = 0.25, p = 0.001) for SICU patients with a faster decline in eHSP70. The area under the receiver operating characteristic curve was 0.85 (95% CI: 0.76 to 0.94) for the final model suggesting excellent discrimination between SICU survivors and non-survivors. GLN-PN did not alter eHSP70 or eHSP27 serum concentrations over time compared to STD-PN.

conclusionOur results suggest that serum HSP70 concentration may be an important marker for severity of illness and likelihood of recovery in the SICU. GLN-supplemented-PN did not increase eHSP70.

Indexed as

AdultCritical CareCritical IllnessCytokinesDouble-Blind MethodFemaleGlutamineHSP70 Heat-Shock ProteinsHumansIntensive Care UnitsMaleParenteral NutritionCytokinesGlutamineHSP70 Heat-Shock ProteinsCritical careGlutamineHeat shock proteinsHospital-acquired infectionParenteral nutrition

Identifiers

PMID30981628
PMCPMC6814516
OpenAlexW2922388369

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.