Glutamine Enriched Total Parenteral Feeding and Proline Metabolism in Severely Burned Patients
Recruitment status was: Recruiting
Proline is a non-essential amino acid that helps with collagen formation. Collagen is one of the main ingredients of skin, bone, tendons, and connective tissue. It is thought that proline becomes depleted in burn patients because it is being used in greater than normal quantities to help the injured skin and connective tissue heal. If this is true, then the body must look for alternate energy sources as proline becomes depleted.
This study aims to evaluate 1)the metabolic kinetics of the amino acids proline, glutamate, and ornithine and 2) the effects of glutamine supplemented total parenteral nutrition (TPN) on the metabolism of these amino acids.
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||Glutamine Enriched Total Parenteral Feeding and Proline Metabolism in Severely Burned Patients.|
- This is a study for measuring the protein kinetics for metabolism of the amino acids proline, glutamate, and ornithine. Kinetics will be derived from measurements on blood and air samples taken as part of the study. [ Time Frame: 12 hours ] [ Designated as safety issue: No ]
|Study Start Date:||August 1997|
|Estimated Study Completion Date:||January 2010|
|Estimated Primary Completion Date:||January 2010 (Final data collection date for primary outcome measure)|
No Intervention: 1
To study proline balance; the quantitative relationships among proline, ornithine and glutamate with an emphasis on evaluating the rate of proline disposal and conversion to ornithine and glutamate in burn patients.
Dietary Supplement: TPN or TPN enriched with glutamine
Each patient undergoes two nutritional support periods either with or without Glutamine supplementation.
No Intervention: 2
This study serves the purpose of evaluating the conversion rate of ornithine and glutamate to proline and the rate of proline de novo synthesis using stable isotopic tracers.
Proline is a nutritionally dispensable (non-essential) amino acid. Its synthesis and catabolism is via the pathway of ornithine and glutamate. The latter two amino acids serve as immediate precursors for proline, as well as metabolites. Ornithine is one of the intermediates for urea cycle. Glutamate is metabolically connected to tricarboxylic acid (TCA) cycle, the major cycle for energy production.
It is hypothesized that the significantly increased rates of net nitrogen loss and energy "production", as the consequence of the accelerated activities of both the urea and TCA cycles in burn injury "drain" both ornithine and glutamate, thus depleting tissues of the availability of proline. Hence, the de novo synthesis of proline is likely to be affected by the reduced availability of its major precursors: glutamate and ornithine. We further propose that increased supply of glutamine would increase the de novo synthesis of proline and / or spare the loss of proline via its metabolite glutamate. Hence, glutamine will be beneficial to the overall nutritional status of the burn patients.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00217035
|United States, Massachusetts|
|Massachusetts General Hospital Burn Unit|
|Boston, Massachusetts, United States, 02114|
|Principal Investigator:||Ronald G Tompkins, MD, ScD||MGH, Shriners Burn Hospital - Boston|