THE IMPORTANCE OF PROTEIN METABOLISM AND LIVER FUNCTION IN GERIATRIC SURGICAL PATIENTS

BACKGROUND: Critically ill patients commonly suffer from infections that require antimicrobial therapy. In previous studies, liver dysfunction was shown to have an essential impact on the dose selection in these patients. This pilot study aims to assess the influence of liver dysfunction, measured by the novel LiMAx test, on clinical outcomes in critically ill patients treated with linezolid. METHODS: Twenty-nine critically ill patients were included and treated with linezolid. Indications for linezolid therapy were secondary or tertiary peritonitis (46.7%), bloodstream infection (6.7%) and 46.7% were other infections with gram-positive bacteria. Linezolid Cmin, maximal liver function capacity (LiMAx test) and plasma samples were collected while linezolid therapy was in a steady-state condition. Furthermore, potential factors for the clinical outcome were investigated using logistic regression analysis. Clinical cure was defined as the resolution or significant improvement of clinical symptoms without using additional antibiotic therapy or intervention. RESULTS: Cured patients presented lower median linezolid Cmin yet a significantly higher mean LiMAx-value compared to the clinical failure group (1.9 mg/L vs. 5.1 mg/L) (349 μg/kg/h vs. 131 μg/kg/h). In the logistic regression model, LiMAx < 178 μg/kg/h was the only independent predictor of clinical failure with a sensitivity of 77% and specificity of 93%. CONCLUSIONS: The LiMAx test predicts clinical failure more precisely than linezolid trough levels in critically ill surgical patients. Therefore liver failure may have a stronger impact on the outcome of critically ill surgical patients than low linezolid Cmin. While linezolid Cmin failed to predict patient’s outcome, LiMAx results were the only independent predictor of clinical failure.

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Effect of Nutritional Substrates on Muscle Amino Acid and Protein Metabolism in Surgical Patients

Clinical Nutrition and Metabolic Research ◽

10.1159/000413369 ◽

2015 ◽

pp. 54-65

Author(s):

P. D. Greig ◽

A. E. Grote ◽

J. Askanazi ◽

Ch. B. Michelsen ◽

D. H. Elwyn ◽

...

Keyword(s):

Amino Acid ◽

Protein Metabolism ◽

Surgical Patients

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O.108 Six years experience of determination of body protein metabolism in surgical patients using L-[1-14C] leucine

Clinical Nutrition ◽

10.1016/s0261-5614(83)80108-3 ◽

1983 ◽

Vol 2 ◽

pp. 55

Author(s):

M.B. Clague ◽

J.A. Inglis ◽

G. Jones ◽

I.D.A. Johnston

Keyword(s):

Protein Metabolism ◽

Surgical Patients ◽

Body Protein

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Protein Metabolism in Surgical Patients

AJN American Journal of Nursing ◽

10.2307/3458018 ◽

1948 ◽

Vol 48 (7) ◽

pp. 415

Author(s):

Stanley M. Levenson ◽

Charles C. Lund

Keyword(s):

Protein Metabolism ◽

Surgical Patients

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Metabolism in calves two weeks before diarrhea at the age of 19-52 days of life

IOP Conference Series Earth and Environmental Science ◽

10.1088/1755-1315/935/1/012008 ◽

2021 ◽

Vol 935 (1) ◽

pp. 012008

Author(s):

N Malkova ◽

M Ostyakova ◽

S Shcherbinina ◽

V Irkhina

Keyword(s):

Liver Function ◽

Protein Metabolism ◽

Blood Test ◽

Digestive System ◽

Mineral Metabolism ◽

Metabolic Status ◽

Disease Manifestation ◽

Holstein Breed ◽

Blood Tests ◽

Young Cattle

Abstract The article presents data on the study of metabolism in calves two weeks before diarrhea at the age of 19-52 days of life. For this purpose, three groups of conditionally healthy animals of the Holstein breed were formed at the age of 19, 30, 52 days of life. To assess the metabolic status of young cattle, biochemical and general clinical blood tests were carried out. In the course of a laboratory blood test in young cattle, two weeks before disease manifestation, disorders of mineral and protein metabolism, a decrease in liver function were established. At the same time, with the increase in the age of the calves, the imbalance in protein metabolism was aggravated against the background of a change in diet and mineral metabolism improved as a result of the maturation of the digestive system.

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