Glycine and ammonia plasma concentrations during sedation with remifentanil in critically ill patients
Identifieur interne : 000813 ( Istex/Corpus ); précédent : 000812; suivant : 000814Glycine and ammonia plasma concentrations during sedation with remifentanil in critically ill patients
Auteurs : Marie-Pierre Bonnet ; Vincent Minville ; Karim Asehnoune ; Delphine Bridoux ; Joséphine Poggi-Bach ; Jacques Duranteau ; Dan BenhamouSource :
- Intensive Care Medicine [ 0342-4642 ] ; 2007-07-01.
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Abstract
Abstract: Objectives: To investigate glycine and ammonia plasma concentrations during a 72-h remifentanil infusion and the relationship between glycine concentration and remifentanil infusion rate. Design and setting: A prospective open-label observational clinical trial in a trauma and a neurosurgical intensive care unit in a university teaching hospital. Patients: Nine consecutive patients requiring sedation and ventilatory support for at least 72 h. One was excluded due to acute cardiac failure. Interventions: Patients were sedated with remifentanil and propofol. Glycine and ammonia plasma concentrations were measured every 12 h during an intravenous remifentanil infusion performed over 72 h, and 24 h after the end of the infusion. Cumulative remifentanil dose and rate of infusion were recorded for each patient. Clinical and biological signs of glycine toxicity were evaluated. Measurements and results: Glycine and ammonia plasma concentrations did not exceed the toxic threshold at any time. Plasma glycine concentration measured at the end of remifentanil infusion was significantly correlated with the mean weighted rate of remifentanil infusion and with the cumulative remifentanil dose. A correlation between plasma glycine concentration and creatinine clearance at the end of remifentanil infusion was also documented. Conclusions: Plasma glycine concentration was correlated with the remifentanil cumulative dose and the infusion rate and did not reach the toxic threshold. As glycine concentration was also correlated with creatinine clearance and because remifentanil was the only source of exogenous glycine, additional data are necessary to ascertain the safety of remifentanil infusion in ICU patients.
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DOI: 10.1007/s00134-007-0574-6
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ISTEX:74AEA0C8A11CBAADE56D899930DBF8AF4A87D28DLe document en format XML
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Toulouse University Hospital, Paul Sabatier University, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Asehnoune, Karim" sort="Asehnoune, Karim" uniqKey="Asehnoune K" first="Karim" last="Asehnoune">Karim Asehnoune</name><affiliation><mods:affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</mods:affiliation></affiliation></author><author><name sortKey="Bridoux, Delphine" sort="Bridoux, Delphine" uniqKey="Bridoux D" first="Delphine" last="Bridoux">Delphine Bridoux</name><affiliation><mods:affiliation>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</mods:affiliation></affiliation></author><author><name sortKey="Poggi Bach, Josephine" sort="Poggi Bach, Josephine" uniqKey="Poggi Bach J" first="Joséphine" last="Poggi-Bach">Joséphine 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Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</mods:affiliation></affiliation></author><author><name sortKey="Minville, Vincent" sort="Minville, Vincent" uniqKey="Minville V" first="Vincent" last="Minville">Vincent Minville</name><affiliation><mods:affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Anesthesia and Intensive Care, Toulouse University Hospital, Paul Sabatier University, Toulouse, France</mods:affiliation></affiliation></author><author><name sortKey="Asehnoune, Karim" sort="Asehnoune, Karim" uniqKey="Asehnoune K" first="Karim" last="Asehnoune">Karim Asehnoune</name><affiliation><mods:affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</mods:affiliation></affiliation></author><author><name sortKey="Bridoux, Delphine" sort="Bridoux, Delphine" uniqKey="Bridoux D" first="Delphine" last="Bridoux">Delphine Bridoux</name><affiliation><mods:affiliation>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</mods:affiliation></affiliation></author><author><name sortKey="Poggi Bach, Josephine" sort="Poggi Bach, Josephine" uniqKey="Poggi Bach J" first="Joséphine" last="Poggi-Bach">Joséphine Poggi-Bach</name><affiliation><mods:affiliation>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</mods:affiliation></affiliation></author><author><name sortKey="Duranteau, Jacques" sort="Duranteau, Jacques" uniqKey="Duranteau J" first="Jacques" last="Duranteau">Jacques Duranteau</name><affiliation><mods:affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</mods:affiliation></affiliation></author><author><name sortKey="Benhamou, Dan" sort="Benhamou, Dan" uniqKey="Benhamou D" first="Dan" last="Benhamou">Dan Benhamou</name><affiliation><mods:affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: dan.benhamou@bct.aphp.fr</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Intensive Care Medicine</title><title level="j" type="abbrev">Intensive Care Med</title><idno type="ISSN">0342-4642</idno><idno type="eISSN">1432-1238</idno><imprint><publisher>Springer-Verlag</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="2007-07-01">2007-07-01</date><biblScope unit="volume">33</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="1179">1179</biblScope><biblScope unit="page" to="1182">1182</biblScope></imprint><idno type="ISSN">0342-4642</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0342-4642</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Ammonia</term><term>Glycine</term><term>Intensive care unit</term><term>Remifentanil</term><term>Sedation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Objectives: To investigate glycine and ammonia plasma concentrations during a 72-h remifentanil infusion and the relationship between glycine concentration and remifentanil infusion rate. Design and setting: A prospective open-label observational clinical trial in a trauma and a neurosurgical intensive care unit in a university teaching hospital. Patients: Nine consecutive patients requiring sedation and ventilatory support for at least 72 h. One was excluded due to acute cardiac failure. Interventions: Patients were sedated with remifentanil and propofol. Glycine and ammonia plasma concentrations were measured every 12 h during an intravenous remifentanil infusion performed over 72 h, and 24 h after the end of the infusion. Cumulative remifentanil dose and rate of infusion were recorded for each patient. Clinical and biological signs of glycine toxicity were evaluated. Measurements and results: Glycine and ammonia plasma concentrations did not exceed the toxic threshold at any time. Plasma glycine concentration measured at the end of remifentanil infusion was significantly correlated with the mean weighted rate of remifentanil infusion and with the cumulative remifentanil dose. A correlation between plasma glycine concentration and creatinine clearance at the end of remifentanil infusion was also documented. Conclusions: Plasma glycine concentration was correlated with the remifentanil cumulative dose and the infusion rate and did not reach the toxic threshold. As glycine concentration was also correlated with creatinine clearance and because remifentanil was the only source of exogenous glycine, additional data are necessary to ascertain the safety of remifentanil infusion in ICU patients.</div></front></TEI><istex><corpusName>springer-journals</corpusName><author><json:item><name>Marie-Pierre Bonnet</name><affiliations><json:string>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</json:string></affiliations></json:item><json:item><name>Vincent Minville</name><affiliations><json:string>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</json:string><json:string>Department of Anesthesia and Intensive Care, Toulouse University Hospital, Paul Sabatier University, Toulouse, France</json:string></affiliations></json:item><json:item><name>Karim Asehnoune</name><affiliations><json:string>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</json:string></affiliations></json:item><json:item><name>Delphine Bridoux</name><affiliations><json:string>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</json:string></affiliations></json:item><json:item><name>Joséphine Poggi-Bach</name><affiliations><json:string>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</json:string></affiliations></json:item><json:item><name>Jacques Duranteau</name><affiliations><json:string>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</json:string></affiliations></json:item><json:item><name>Dan Benhamou</name><affiliations><json:string>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</json:string><json:string>E-mail: dan.benhamou@bct.aphp.fr</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Remifentanil</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Glycine</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Ammonia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Sedation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Intensive care unit</value></json:item></subject><articleId><json:string>574</json:string><json:string>s00134-007-0574-6</json:string></articleId><arkIstex>ark:/67375/VQC-7C0WBG9Z-D</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>Report</json:string></originalGenre><abstract>Abstract: Objectives: To investigate glycine and ammonia plasma concentrations during a 72-h remifentanil infusion and the relationship between glycine concentration and remifentanil infusion rate. Design and setting: A prospective open-label observational clinical trial in a trauma and a neurosurgical intensive care unit in a university teaching hospital. Patients: Nine consecutive patients requiring sedation and ventilatory support for at least 72 h. One was excluded due to acute cardiac failure. Interventions: Patients were sedated with remifentanil and propofol. Glycine and ammonia plasma concentrations were measured every 12 h during an intravenous remifentanil infusion performed over 72 h, and 24 h after the end of the infusion. Cumulative remifentanil dose and rate of infusion were recorded for each patient. Clinical and biological signs of glycine toxicity were evaluated. Measurements and results: Glycine and ammonia plasma concentrations did not exceed the toxic threshold at any time. Plasma glycine concentration measured at the end of remifentanil infusion was significantly correlated with the mean weighted rate of remifentanil infusion and with the cumulative remifentanil dose. A correlation between plasma glycine concentration and creatinine clearance at the end of remifentanil infusion was also documented. Conclusions: Plasma glycine concentration was correlated with the remifentanil cumulative dose and the infusion rate and did not reach the toxic threshold. As glycine concentration was also correlated with creatinine clearance and because remifentanil was the only source of exogenous glycine, additional data are necessary to ascertain the safety of remifentanil infusion in ICU patients.</abstract><qualityIndicators><refBibsNative>false</refBibsNative><abstractWordCount>233</abstractWordCount><abstractCharCount>1730</abstractCharCount><keywordCount>5</keywordCount><score>6.883</score><pdfWordCount>2087</pdfWordCount><pdfCharCount>14770</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>4</pdfPageCount><pdfPageSize>595 x 791 pts</pdfPageSize></qualityIndicators><title>Glycine and ammonia plasma concentrations during sedation with remifentanil in critically ill patients</title><genre><json:string>research-article</json:string></genre><host><title>Intensive Care 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Sabatier University, Toulouse, France</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Karim</forename><surname>Asehnoune</surname></persName><affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Delphine</forename><surname>Bridoux</surname></persName><affiliation>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Joséphine</forename><surname>Poggi-Bach</surname></persName><affiliation>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Jacques</forename><surname>Duranteau</surname></persName><affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation></author><author xml:id="author-0006" corresp="yes"><persName><forename type="first">Dan</forename><surname>Benhamou</surname></persName><email>dan.benhamou@bct.aphp.fr</email><affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation></author><idno type="istex">74AEA0C8A11CBAADE56D899930DBF8AF4A87D28D</idno><idno type="ark">ark:/67375/VQC-7C0WBG9Z-D</idno><idno type="DOI">10.1007/s00134-007-0574-6</idno><idno type="article-id">574</idno><idno type="article-id">s00134-007-0574-6</idno></analytic><monogr><title level="j">Intensive Care Medicine</title><title level="j" type="abbrev">Intensive Care Med</title><idno type="pISSN">0342-4642</idno><idno 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Design and setting: A prospective open-label observational clinical trial in a trauma and a neurosurgical intensive care unit in a university teaching hospital. Patients: Nine consecutive patients requiring sedation and ventilatory support for at least 72 h. One was excluded due to acute cardiac failure. Interventions: Patients were sedated with remifentanil and propofol. Glycine and ammonia plasma concentrations were measured every 12 h during an intravenous remifentanil infusion performed over 72 h, and 24 h after the end of the infusion. Cumulative remifentanil dose and rate of infusion were recorded for each patient. Clinical and biological signs of glycine toxicity were evaluated. Measurements and results: Glycine and ammonia plasma concentrations did not exceed the toxic threshold at any time. Plasma glycine concentration measured at the end of remifentanil infusion was significantly correlated with the mean weighted rate of remifentanil infusion and with the cumulative remifentanil dose. A correlation between plasma glycine concentration and creatinine clearance at the end of remifentanil infusion was also documented. Conclusions: Plasma glycine concentration was correlated with the remifentanil cumulative dose and the infusion rate and did not reach the toxic threshold. As glycine concentration was also correlated with creatinine clearance and because remifentanil was the only source of exogenous glycine, additional data are necessary to ascertain the safety of remifentanil infusion in ICU patients.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Remifentanil</term></item><item><term>Glycine</term></item><item><term>Ammonia</term></item><item><term>Sedation</term></item><item><term>Intensive care unit</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Medicine & Public Health</head><item><term>Pediatrics</term></item><item><term>Pain Medicine</term></item><item><term>Pneumology/Respiratory System</term></item><item><term>Emergency Medicine</term></item><item><term>Anesthesiology</term></item><item><term>Intensive / Critical Care Medicine</term></item></list></keywords></textClass></profileDesc><revisionDesc><change 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TocLevels="0"><IssueIDStart>7</IssueIDStart><IssueIDEnd>7</IssueIDEnd><IssueArticleCount>39</IssueArticleCount><IssueHistory><OnlineDate><Year>2007</Year><Month>6</Month><Day>22</Day></OnlineDate><PrintDate><Year>2007</Year><Month>6</Month><Day>22</Day></PrintDate><CoverDate><Year>2007</Year><Month>7</Month></CoverDate></IssueHistory><IssueCopyright><CopyrightHolderName>Springer-Verlag</CopyrightHolderName><CopyrightYear>2007</CopyrightYear></IssueCopyright></IssueInfo><Article ID="s00134-007-0574-6" OutputMedium="All"><ArticleInfo ArticleType="Report" ContainsESM="Yes" Language="En" NumberingStyle="Unnumbered" TocLevels="0"><ArticleID>574</ArticleID><ArticleDOI>10.1007/s00134-007-0574-6</ArticleDOI><ArticleSequenceNumber>12</ArticleSequenceNumber><ArticleTitle Language="En">Glycine and ammonia plasma concentrations during sedation with remifentanil in critically ill patients</ArticleTitle><ArticleCategory>Brief Report</ArticleCategory><ArticleFirstPage>1179</ArticleFirstPage><ArticleLastPage>1182</ArticleLastPage><ArticleHistory><RegistrationDate><Year>2007</Year><Month>2</Month><Day>1</Day></RegistrationDate><Received><Year>2006</Year><Month>12</Month><Day>21</Day></Received><Accepted><Year>2007</Year><Month>1</Month><Day>31</Day></Accepted><OnlineDate><Year>2007</Year><Month>3</Month><Day>9</Day></OnlineDate></ArticleHistory><ArticleCopyright><CopyrightHolderName>Springer-Verlag</CopyrightHolderName><CopyrightYear>2007</CopyrightYear></ArticleCopyright><ArticleGrants Type="Regular"><MetadataGrant Grant="OpenAccess"></MetadataGrant><AbstractGrant Grant="OpenAccess"></AbstractGrant><BodyPDFGrant Grant="Restricted"></BodyPDFGrant><BodyHTMLGrant Grant="Restricted"></BodyHTMLGrant><BibliographyGrant Grant="Restricted"></BibliographyGrant><ESMGrant Grant="Restricted"></ESMGrant></ArticleGrants></ArticleInfo><ArticleHeader><AuthorGroup><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Marie-Pierre</GivenName><FamilyName>Bonnet</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1 Aff3"><AuthorName DisplayOrder="Western"><GivenName>Vincent</GivenName><FamilyName>Minville</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Karim</GivenName><FamilyName>Asehnoune</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>Delphine</GivenName><FamilyName>Bridoux</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>Joséphine</GivenName><FamilyName>Poggi-Bach</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Jacques</GivenName><FamilyName>Duranteau</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff1" CorrespondingAffiliationID="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Dan</GivenName><FamilyName>Benhamou</FamilyName></AuthorName><Contact><Phone>+33-1-45213447</Phone><Fax>+33-1-45212875</Fax><Email>dan.benhamou@bct.aphp.fr</Email></Contact></Author><Affiliation ID="Aff1"><OrgDivision>Département d’Anesthésie-Réanimation</OrgDivision><OrgName>Bicêtre University Hospital</OrgName><OrgAddress><Street>AP-HP, 78 rue du Général Leclerc</Street><Postcode>94275</Postcode><City>Le Kremlin Bicêtre Cedex</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff2"><OrgDivision>Laboratory of Biochemistry</OrgDivision><OrgName>Bicêtre University Hospital</OrgName><OrgAddress><Street>AP-HP, 78 rue du Général Leclerc</Street><Postcode>94275</Postcode><City>Le Kremlin Bicêtre Cedex</City><Country Code="FR">France</Country></OrgAddress></Affiliation><Affiliation ID="Aff3"><OrgDivision>Department of Anesthesia and Intensive Care, Toulouse University Hospital</OrgDivision><OrgName>Paul Sabatier University</OrgName><OrgAddress><City>Toulouse</City><Country Code="FR">France</Country></OrgAddress></Affiliation></AuthorGroup><Abstract ID="Abs1" Language="En"><Heading>Abstract</Heading><AbstractSection ID="ASec1"><Heading>Objectives</Heading><Para>To investigate glycine and ammonia plasma concentrations during a 72-h remifentanil infusion and the relationship between glycine concentration and remifentanil infusion rate.</Para></AbstractSection><AbstractSection ID="ASec2"><Heading>Design and setting</Heading><Para>A prospective open-label observational clinical trial in a trauma and a neurosurgical intensive care unit in a university teaching hospital.</Para></AbstractSection><AbstractSection ID="ASec3"><Heading>Patients</Heading><Para>Nine consecutive patients requiring sedation and ventilatory support for at least 72 h. One was excluded due to acute cardiac failure.</Para></AbstractSection><AbstractSection ID="ASec4"><Heading>Interventions</Heading><Para>Patients were sedated with remifentanil and propofol. Glycine and ammonia plasma concentrations were measured every 12 h during an intravenous remifentanil infusion performed over 72 h, and 24 h after the end of the infusion. Cumulative remifentanil dose and rate of infusion were recorded for each patient. Clinical and biological signs of glycine toxicity were evaluated.</Para></AbstractSection><AbstractSection ID="ASec5"><Heading>Measurements and results</Heading><Para>Glycine and ammonia plasma concentrations did not exceed the toxic threshold at any time. Plasma glycine concentration measured at the end of remifentanil infusion was significantly correlated with the mean weighted rate of remifentanil infusion and with the cumulative remifentanil dose. A correlation between plasma glycine concentration and creatinine clearance at the end of remifentanil infusion was also documented.</Para></AbstractSection><AbstractSection ID="ASec6"><Heading>Conclusions</Heading><Para>Plasma glycine concentration was correlated with the remifentanil cumulative dose and the infusion rate and did not reach the toxic threshold. As glycine concentration was also correlated with creatinine clearance and because remifentanil was the only source of exogenous glycine, additional data are necessary to ascertain the safety of remifentanil infusion in ICU patients.</Para></AbstractSection></Abstract><KeywordGroup Language="En"><Heading>Keywords</Heading><Keyword>Remifentanil</Keyword><Keyword>Glycine</Keyword><Keyword>Ammonia</Keyword><Keyword>Sedation</Keyword><Keyword>Intensive care unit</Keyword></KeywordGroup><ArticleNote Type="ESMHint"><Heading>Electronic supplementary material</Heading><SimplePara>The online version of this article (doi:<ExternalRef><RefSource>10.1007/s00134-007-0574-6</RefSource><RefTarget Address="http://dx.doi.org/10.1007/s00134-007-0574-6" TargetType="URL"></RefTarget></ExternalRef>) contains supplementary material, which is available to authorized users</SimplePara></ArticleNote></ArticleHeader><NoBody></NoBody></Article></Issue></Volume></Journal></Publisher></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Glycine and ammonia plasma concentrations during sedation with remifentanil in critically ill patients</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Glycine and ammonia plasma concentrations during sedation with remifentanil in critically ill patients</title></titleInfo><name type="personal"><namePart type="given">Marie-Pierre</namePart><namePart type="family">Bonnet</namePart><affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Vincent</namePart><namePart type="family">Minville</namePart><affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation><affiliation>Department of Anesthesia and Intensive Care, Toulouse University Hospital, Paul Sabatier University, Toulouse, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karim</namePart><namePart type="family">Asehnoune</namePart><affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Delphine</namePart><namePart type="family">Bridoux</namePart><affiliation>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joséphine</namePart><namePart type="family">Poggi-Bach</namePart><affiliation>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jacques</namePart><namePart type="family">Duranteau</namePart><affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Dan</namePart><namePart type="family">Benhamou</namePart><affiliation>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France</affiliation><affiliation>E-mail: dan.benhamou@bct.aphp.fr</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Report" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Springer-Verlag</publisher><place><placeTerm type="text">Berlin/Heidelberg</placeTerm></place><dateCreated encoding="w3cdtf">2006-12-21</dateCreated><dateIssued encoding="w3cdtf">2007-07-01</dateIssued><dateIssued encoding="w3cdtf">2007</dateIssued><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract lang="en">Abstract: Objectives: To investigate glycine and ammonia plasma concentrations during a 72-h remifentanil infusion and the relationship between glycine concentration and remifentanil infusion rate. Design and setting: A prospective open-label observational clinical trial in a trauma and a neurosurgical intensive care unit in a university teaching hospital. Patients: Nine consecutive patients requiring sedation and ventilatory support for at least 72 h. One was excluded due to acute cardiac failure. Interventions: Patients were sedated with remifentanil and propofol. Glycine and ammonia plasma concentrations were measured every 12 h during an intravenous remifentanil infusion performed over 72 h, and 24 h after the end of the infusion. Cumulative remifentanil dose and rate of infusion were recorded for each patient. Clinical and biological signs of glycine toxicity were evaluated. Measurements and results: Glycine and ammonia plasma concentrations did not exceed the toxic threshold at any time. Plasma glycine concentration measured at the end of remifentanil infusion was significantly correlated with the mean weighted rate of remifentanil infusion and with the cumulative remifentanil dose. A correlation between plasma glycine concentration and creatinine clearance at the end of remifentanil infusion was also documented. Conclusions: Plasma glycine concentration was correlated with the remifentanil cumulative dose and the infusion rate and did not reach the toxic threshold. As glycine concentration was also correlated with creatinine clearance and because remifentanil was the only source of exogenous glycine, additional data are necessary to ascertain the safety of remifentanil infusion in ICU patients.</abstract><note>Brief Report</note><subject lang="en"><genre>Keywords</genre><topic>Remifentanil</topic><topic>Glycine</topic><topic>Ammonia</topic><topic>Sedation</topic><topic>Intensive care unit</topic></subject><relatedItem type="host"><titleInfo><title>Intensive Care Medicine</title></titleInfo><titleInfo type="abbreviated"><title>Intensive Care Med</title></titleInfo><genre type="journal" displayLabel="Archive Journal" authority="ISTEX" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>Springer</publisher><dateIssued encoding="w3cdtf">2007-06-22</dateIssued><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><subject><genre>Medicine & Public Health</genre><topic>Pediatrics</topic><topic>Pain Medicine</topic><topic>Pneumology/Respiratory System</topic><topic>Emergency Medicine</topic><topic>Anesthesiology</topic><topic>Intensive / Critical Care Medicine</topic></subject><identifier type="ISSN">0342-4642</identifier><identifier type="eISSN">1432-1238</identifier><identifier type="JournalID">134</identifier><identifier type="IssueArticleCount">39</identifier><identifier type="VolumeIssueCount">12</identifier><part><date>2007</date><detail type="volume"><number>33</number><caption>vol.</caption></detail><detail type="issue"><number>7</number><caption>no.</caption></detail><extent unit="pages"><start>1179</start><end>1182</end></extent></part><recordInfo><recordOrigin>Springer-Verlag, 2007</recordOrigin></recordInfo></relatedItem><identifier type="istex">74AEA0C8A11CBAADE56D899930DBF8AF4A87D28D</identifier><identifier type="ark">ark:/67375/VQC-7C0WBG9Z-D</identifier><identifier type="DOI">10.1007/s00134-007-0574-6</identifier><identifier type="ArticleID">574</identifier><identifier type="ArticleID">s00134-007-0574-6</identifier><accessCondition type="use and reproduction" contentType="copyright">Springer-Verlag, 2007</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-3XSW68JL-F">springer</recordContentSource><recordOrigin>Springer-Verlag, 2007</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/document/74AEA0C8A11CBAADE56D899930DBF8AF4A87D28D/metadata/json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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