Influence of Gastroenterological Surgery on the Plasma Glutamine Levels

Hisanori Shiomi, Tohru Tani, Yoshihiro Endo, Kaoru Endo, Tohru Shiraishi, Hisakazu Hoshi, Naoki Kakihara, Masashi Kodama

First Department of Surgery, Shiga University of Medical Science

Glutamine (Gln) is the preferred fuel by enterocytes and so on and this has been documented in a number of animal studies. But plasma Gln levels under surgical stress have not been confirmed in man. Plasma Gln levels of 39 patients who underwent gastroenterological surgery and 12 patients during fasting were measured. The change rate of plasma Gln levels was negative after surgical stress. It was lowest at post-operative-day l and nearly 0%/day at post operative-day 4. Total parenteral nutrition (TPN) tends to suppress the decline in plasma Gln levels, but there was no way to raise plasma Gln levers except by food intake. Moreover, plasma Gln levels decline further after 2 weeks of surgical stress or fasting under TPN. In these circumstances, 3 or 4 days are necessary to e equal Gln consumption and Gln supply from muscle. For muscle Gln lakc the supply does not catch up with Gln consumption after 2 weeks of fasting, and Gln supplementation is indicated.

Key words
Glutamine, gastroenterological surgery

Reprint requests
Hisanori Shiomi First Department of Surgery, Shiga University of Medical Science
Setatsukinowa-chou, Ohtsu city, 520-21, JAPAN

Accepted
November 13, 1996

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