A descriptive study of skeletal muscle metabolism in critically ill patients: free amino acids, energy-rich phosphates, protein, nucleic acids, fat, water, and electrolytes

Critical Care Medicine
L GamrinJan Wernerman

Abstract

To characterize biochemical changes in skeletal muscle in critically ill patients. Survey of critically ill patients. Intensive care unit (ICU) at a university hospital. Critically ill patients (n = 20) subjected to trauma, surgical complications, and/or bacteremia who were treated in the ICU and showed no risk of bleeding complications were included. Reference groups of metabolically healthy volunteers and patients served as the control/reference groups. Percutaneous muscle biopsy was obtained from both patients and healthy volunteers. Total free amino acids in skeletal muscle decreased 59% (p < .001) and skeletal muscle glutamine concentration decreased 72% (p < .001) in the critically ill patients. Basic amino acids decreased 49% (p < .001). Branch-chain amino acids increased 39% (p < .01), and aromatic amino acids increased 88% (p < .001) in the patients. Adenosine triphosphate (ATP) was reduced by 12% (p < .01). Total creatine concentration increased by 26% (p < .001) due to an 80% increase in free creatine (p < .001). The phosphorylated creatine fraction of total creatine decreased 22% (p < .001) in the patients. Alkali-soluble protein/DNA decreased 24% (p < .01) and fat free solid/DNA decreased 21% (P <.01) in patients s...Continue Reading

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