Surgery
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Plasma metabolic changes have been shown to reflect deterioration of the energy state of tissue in studies in animals. This study evaluates whether high-energy compounds and their metabolites in plasma reflect the clinical condition and predict outcome in critically ill patients. ⋯ Grouping patients with successively higher APACHE II scores revealed specific patterns of altered plasma metabolism, possible reflecting different levels of tissue adenylate energy charge. However, neither the initial individual APACHE II score nor any initial plasma metabolic level had any prognostic value in this group of critically ill patients, although the deterioration of the physiologic parameters was coexistent with specific metabolic changes.