scholarly journals Compromised Glutamine - Glutamate Metabolism in a Pseudomonas Aeruginosa Induced Hyperdynamic Sepsis-Recovery Pig Model During an Anabolic Nutritional Intervention

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1147-1147
Author(s):  
Gabriella Ten Have ◽  
Marielle Engelen ◽  
Robert Wolfe ◽  
Nicolaas Deutz
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Amino Acid ◽  
Essential Amino Acid ◽  
Plasma Concentrations ◽  
Daily Intake ◽  
Test Group ◽  
Nutritional Intervention ◽  
Recovery Phase ◽  
Early Recovery ◽  
Early Recovery Phase

Abstract Objectives Optimal feeding in patients recovering from sepsis is critical to preserve muscle mass. In sepsis, glutamine (Gln) is considered a conditional essential amino acid and low plasma level of its precursor glutamate (Glu), is associated with higher mortality. An essential amino acid (EAA) mixture restores protein anabolism in the early recovery phase of acute septicemia in the pig. However, it is unclear whether interorgan Glu-Gln kinetics is also improved. Therefore, we measured the interorgan kinetics of Glu-Gln during a nutritional intervention with a balanced free amino acid (TAA) or EAA mixture in the early recovery phase of acute septicemia in the pig. Methods In catheterized pigs (±25 kg), acute septicemia was present for 6 hours (Pseudomonas aeruginosa: 3e,8 CFU/ml/h IV). At t = 6 h, recovery was started by a single dose gentamycin (5 mg/kg) and intra-gastric continuous feeding of a balanced free TAA or EAA mixture (pig muscle profile, 31 mg N/kg bw/h, 30% daily intake and dextrose 781 mg/kg bw/h) for 6 hours. We studied 3 groups (Healthy: H-TAA n = 12; Sepsis: S-TAA n = 13, S-EAA n = 12) over the last 3 hours of the intervention by measuring arterial and venous plasma concentrations (expressed as mean[low, high 95%CI]) and organ net balances of the portal drained viscera (PDV), liver, kidneys and hindquarter (HQ, muscle). Statistics: Net balances were tested with Wilcoxon Signed Rank Test. Group comparisons with ANOVA. Significance: P < 0.05. Results Plasma concentrations : Gln was increased only in S-EAA (23 [14,32]%) group. In contrast, Glu substantially decreased in S-TAA and S-EAA (32[25,40]; 35[28,43]%) groups. Net PDV balance:Increased Gln uptake in S-EAA (P = 0.0020), but zero balance of Glu. Net HQ balance: Gln release was higher in S-TAA and S-EAA(P = 0.0028;0.0143). However, no changes in Glu uptake. Net liver balance: Gln uptake was higher in S-TAA and S-EAA (P = 0.0155;0.0056). Reduced Glu release in S-TAA (P = 0.0250). Net kidney balance: Zero balance for Gln, Glu uptake decreased in S-TAA (P = 0.0403). Conclusions In the present model of an early recovery of septicemia, interorgan Glu-Gln metabolism and Glu plasma levels are not restored by anabolic intervention, suggesting additional supplementation needs. Funding Sources NIH R01GM084447 and S10RR027047.

scholarly journals The role of precipitation losses in producing the rapid early recovery phase of the Great Magnetic Storm of February 1986

1998 ◽  
Vol 103 (A4) ◽  
pp. 6801-6814 ◽  
Author(s):  
J. U. Kozyra ◽  
M.-C. Fok ◽  
E. R. Sanchez ◽  
D. S. Evans ◽  
D. C. Hamilton ◽  
...  
Keyword(s):  
Magnetic Storm ◽  
Recovery Phase ◽  
Early Recovery ◽  
Early Recovery Phase

Abstract 17270: Prognostic Impact of Ventricular Ectopy During the Recovery Phase of Stress Testing: A Meta-Analysis

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Muhammad T Ayub ◽  
Muhammad S Khan ◽  
Sagar Ranka ◽  
Muhammad Ishaq ◽  
Muhammad F Khalid ◽  
...  
Keyword(s):  
Stress Testing ◽  
Meta Analysis ◽  
Recovery Phase ◽  
Prognostic Impact ◽  
Ventricular Ectopy ◽  
Early Recovery ◽  
Premature Ventricular Contractions ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Early Recovery Phase

Introduction: Ventricular ectopy after exercise, due to parasympathetic activity, predicts an increased risk of death in population-based cohorts. We sought to examine the composite risk of all cause mortality in patients with premature ventricular contractions (PVCs) in the early recovery phase of stress testing. Methods: PubMed, Medline & EMBASE were queried for all English language articles from 1993 to 2017. The primary outcome was incidence of all cause mortality in patients with frequent PVCs during recovery phase (RPV) of stress testing. Frequent PVCs were defined as the presence of seven or more ventricular premature beats/min, frequent ventricular couplets, ventricular bigeminy or trigeminy, or any other form of ventricular tachycardia or ventricular fibrillation. Meta-analysis of the main outcome was performed using a weighted random effects model. Results: A total of four observational studies including 38765 patients were retrieved. Data for 2065 patients with RPV was pooled. A comparative analysis of PVC vs Infrequent/Non-PVC group showed a calculated risk ratio for all cause mortality of 1.8 (95% CI 1.36-2.38; p=0.001). I 2 statistic for heterogeneity testing was 82.8% (Fig.1). Conclusion: Frequent premature ventricular contractions during early recovery phase of stress testing are associated with increased all cause mortality as compared to patients with infrequent or no PVCs.

Abstract 2142: Diagnostic and Prognostic Value of Augmented ST-Segment Elevation at Exercise Testing in Patients with Brugada Syndrome

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Hisaki Makimoto ◽  
Eiichiro Nakagawa ◽  
Hiroshi Takaki ◽  
Kenichiro Yamagata ◽  
Hiro Kawata ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Brugada Syndrome ◽  
Recovery Phase ◽  
Peak Exercise ◽  
Early Recovery ◽  
St Segment Elevation ◽  
St Segment ◽  
History Of ◽  
Diagnostic And Prognostic Value ◽  
Early Recovery Phase

Background : It has been reported that ST-segment elevation was augmented at early recovery phase or at peak exercise during exercise testing in some patients with Brugada syndrome (BrS), but its diagnostic and prognostic value has not fully been clarified. Methods : Treadmill exercise testing (TMT) was conducted in 93 patients (pts) with BrS (22 documented VF, 31 syncope alone, and 40 asymptomatic; 91 males, 46±14 years) and 22 healthy control subjects (20 males, 48±14 years, 11 with incomplete right bundle branch block (RBBB) and 4 with complete RBBB). Results : The augmentation of ST-segment elevation ≥0.05mV in V1-V3 leads compared with that before exercise was observed at early recovery phase (1– 4 minutes at recovery phase) in 32 BrS pts (34%, Group1), at peak exercise in 8 BrS pts (9%, Group 2), but not in either the remaining 53 BrS pts (57%, Group 3) or 22 control subjects. There were no significant differences among the 3 BrS groups in the baseline clinical (age, gender, family history of sudden death, SCN5A mutation), electrocardiographic (PR, QRS duration, QTc interval and ST amplitude), and electrophysiologic (AH, HV interval, and VF induction) variables except for the positive ratio of signal averaged ECG (87%, 48%, 63%; P= 0.001). No significant difference was observed in the proportion of previous cardiac events (VF/syncope/asymptomatic; 6/12/14, 0/3/5, 16/16/21, respectively for Group 1, 2, and 3). During 76.0, 74.8, and 52.0 months follow-up, VF occurred in 12/32 (38%) pts of Group1, 0/8 (0 %) pts of Group2, and 10/53 (19%) pts of Group3. Augmentation of ST-segment elevation at early recovery phase was a significant and an independent predictor for subsequent VF occurrence (12/32 (38%) in Group1 vs. 10/61 (16%) in Group2 and 3; hazard ratio [HR]= 1.68; P=0.014), especially in 31 pts with a history of syncope alone (6/12 (50%) in Group1 vs. 1/19 (5%) in Group2 and 3; HR=3.44; P=0.004). Conclusions : Our data suggest that augmentation of ST-segment elevation at early recovery phase during exercise testing can be a predictor of poor prognosis in patients with Brugada syndrome, especially in those with a history of syncope alone.

Plasma amino acids, prolactin, insulin and glucose concentrations in lactating sows following venous infusion of isoleucine, leucine, lysine, threonine or valine

2014 ◽  
Vol 94 (2) ◽  
pp. 323-330 ◽  
Author(s):  
K. A. G. de Ridder ◽  
C. Farmer ◽  
C. F. M. de Lange ◽  
A. K. Shoveller ◽  
P. H. Luimes
Keyword(s):  
Amino Acids ◽  
Amino Acid ◽  
Plasma Concentrations ◽  
Daily Intake ◽  
Repeated Measurements ◽  
Saline Control ◽  
Plasma Amino Acids ◽  
Isoleucine Leucine ◽  
Lactating Sows ◽  
Venous Infusion

de Ridder, K. A. G., Farmer, C., de Lange, C. F. M., Shoveller, A. K. and Luimes, P. H. 2014. Plasma amino acids, prolactin, insulin and glucose concentrations in lactating sows following venous infusion of isoleucine, leucine, lysine, threonine or valine. Can. J. Anim. Sci. 94: 323–330. The amino acid supply to lactating sows affects their milk yield, and the current study aims at establishing whether this is mediated via increases in concentrations of insulin and prolactin, two hormones that are important for lactation. Six multiparous Yorkshire sows (252.8±18.5 kg body weight) were fitted with an ear vein catheter and were used in a 6×6 Latin square design experiment from days 7 to 10 of lactation (am and pm infusions on 3 consecutive days). Sows were fed a commercial corn and soybean meal diet (17.1% crude protein) three times daily (1.5 kg at 0600 and 1200, 3.0 kg at 1830). Starting 2 h after the 0600 or 1200 feeding, sows received an infusion of saline (control), isoleucine, leucine, lysine, threonine or valine at a rate of 33 mL min−1during 30 min. The infused dose was equivalent to 18±0.9% of true ileal digestible intake for each of the amino acids. Serial blood samples were taken, starting 30 min prior to infusion and until 240 min after infusion. Plasma concentrations of amino acids, prolactin, insulin, and glucose were determined. Data were analyzed as repeated measurements and also using areas under the curve. Intravenous infusion with each of the five amino acids studied increased the corresponding free plasma amino acid concentrations (P<0.05). However, concentrations of prolactin, insulin, and glucose were not affected by infusion of any of the amino acids studied (P>0.10). Therefore, supplying intravenously 18% of the daily intake of isoleucine, leucine, lysine, threonine or valine brings about expected increases in amino acids, but does not alter the short-term response in prolactin, insulin or glucose concentrations of lactating sows.

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