• Tomoya Hirose, Kentaro Shimizu, Hiroshi Ogura, Osamu Tasaki, Toshimitsu Hamasaki, Shuhei Yamano, Mitsuo Ohnishi, Yasuyuki Kuwagata, and Takeshi Shimazu.
• Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. Electronic address: htomoya1979@hp-emerg.med.osaka-u.ac.jp.
• Clin Nutr. 2014 Feb 1;33(1):179-82.

Background & AimsProtein metabolism is important in healing wounds, supporting immune function, and maintaining lean body mass. Determination of adequate requirements of amino acids has not been thoroughly clarified in critically ill patients. The purpose of this study was to evaluate 23 plasma amino acids in patients with sepsis and determine prognostic factors.MethodsThis study was a retrospective study. Plasma aminograms were measured in patients with sepsis. We evaluated minimum and maximum values of each amino acid and evaluated prognostic factors by multivariate logistic regression analysis and classification and regression tree (CART) analysis.ResultsThe study comprised 77 patients. The median intensive care unit (ICU) stay was 30 days (interquartile range 19.5-55.5 days). Whole mortality rate was 39.0%. Maximum values of glutamine, glutamate, glycine, alanine, methionine, phenylalanine, and histidine and minimum values of glutamate, taurine, serine, isoleucine, leucine, tyrosine, ornithine, tryptophan, and arginine were significantly different between survivors and non-survivors (P < 0.05). Statistical analysis using CART analysis revealed the minimum value of glutamate and maximum value of methionine to be significant prognostic factors for mortality (P < 0.05).ConclusionPlasma aminograms were significantly altered in patients with sepsis. Altered balance of aminograms was significantly associated with mortality in patients with sepsis requiring a long ICU stay.Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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