Glycine and ammonia plasma concentrations during sedation with remifentanil in critically ill patients
Identifieur interne : 000399 ( Main/Exploration ); précédent : 000398; suivant : 000400Glycine and ammonia plasma concentrations during sedation with remifentanil in critically ill patients
Auteurs : Marie-Pierre Bonnet [France] ; Vincent Minville [France] ; Karim Asehnoune [France] ; Delphine Bridoux [France] ; Joséphine Poggi-Bach [France] ; Jacques Duranteau [France] ; Dan Benhamou [France]Source :
- 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
Affiliations:
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nuts="2">Île-de-France</region><settlement type="city">Le Kremlin Bicêtre</settlement></placeName></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 wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Laboratory of Biochemistry, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex</wicri:regionArea><placeName><region type="region" nuts="2">Île-de-France</region><settlement type="city">Le Kremlin Bicêtre</settlement></placeName></affiliation></author><author><name sortKey="Duranteau, Jacques" sort="Duranteau, Jacques" uniqKey="Duranteau J" first="Jacques" last="Duranteau">Jacques Duranteau</name><affiliation wicri:level="3"><country xml:lang="fr">France</country><wicri:regionArea>Département d’Anesthésie-Réanimation, Bicêtre University Hospital, AP-HP, 78 rue du Général Leclerc, 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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><affiliations><list><country><li>France</li></country><region><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li><li>Île-de-France</li></region><settlement><li>Le Kremlin Bicêtre</li><li>Toulouse</li></settlement></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Bonnet, Marie Pierre" sort="Bonnet, Marie Pierre" uniqKey="Bonnet M" first="Marie-Pierre" last="Bonnet">Marie-Pierre Bonnet</name></region><name sortKey="Asehnoune, Karim" sort="Asehnoune, Karim" uniqKey="Asehnoune K" first="Karim" last="Asehnoune">Karim Asehnoune</name><name sortKey="Benhamou, Dan" sort="Benhamou, Dan" uniqKey="Benhamou D" first="Dan" last="Benhamou">Dan Benhamou</name><name sortKey="Benhamou, Dan" sort="Benhamou, Dan" uniqKey="Benhamou D" first="Dan" last="Benhamou">Dan Benhamou</name><name sortKey="Bridoux, Delphine" sort="Bridoux, Delphine" uniqKey="Bridoux D" first="Delphine" last="Bridoux">Delphine Bridoux</name><name sortKey="Duranteau, Jacques" sort="Duranteau, Jacques" uniqKey="Duranteau J" first="Jacques" last="Duranteau">Jacques Duranteau</name><name sortKey="Minville, Vincent" sort="Minville, Vincent" uniqKey="Minville V" first="Vincent" last="Minville">Vincent Minville</name><name sortKey="Minville, Vincent" sort="Minville, Vincent" uniqKey="Minville V" first="Vincent" last="Minville">Vincent Minville</name><name sortKey="Poggi Bach, Josephine" sort="Poggi Bach, Josephine" uniqKey="Poggi Bach J" first="Joséphine" last="Poggi-Bach">Joséphine Poggi-Bach</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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