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The S-100B substudy of the GLUTAMICS trial: Glutamate infusion not associated with sustained elevation of plasma S-100B after coronary surgery
Department of Cardiothoracic Surgery and Anesthesia, University Hospital Örebro, Sweden.
Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery.
Östergötlands Läns Landsting, Heart Centre, Department of Thoracic and Vascular Surgery. Linköping University, Department of Medical and Health Sciences, Thoracic Surgery. Linköping University, Faculty of Health Sciences.
Department of Cardiothoracic Surgery and Anesthesia, University Hospital Örebro, Sweden.
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2010 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 29, no 3, 358-364 p.Article in journal (Refereed) Published
Abstract [en]

Background and aims: Concerns have been raised about potential neurological injury related to exogenous glutamate. In cardiac surgery glutamate has been administered as a putative cardioprotective agent by cardioplegia or intravenous infusion. In the GLUTAMICS trial, in addition to surveillance of clinical neurological injuries, a prespecified subgroup was analyzed with regard to postoperative S-100B levels to detect potential subclinical neurological injury related to glutamate infusion. Methods: Sixty-nine patients operated on for unstable coronary syndrome were randomized to intravenous infusion of glutamate (n = 35) or saline (n = 34) perioperatively. Plasma levels of S-100B were obtained on the third postoperative day. Results: S-100B in the glutamate group and the control group were 0.079 +/- 0.034 mu g/L and 0.090 +/- 0.042 mu g/L respectively (p = 0.245). There were no patients with stroke or mortality. Three patients in the control group and two in the glutamate group had postoperative confusion. These patients had significantly elevated S-100B compared with those without confusion (0.132 +/- 0.047 vs 0.081 +/- 0.036 mu g/L; p = 0.003). Overall, 21 patients had S-100B above reference level (greater than= 0.10 mu g/L) and these patients had significantly more calcifications in the ascending aorta on epiaortic scanning. Conclusions: Intravenous glutamate infusion during surgery for unstable coronary artery disease did not initiate a sustained elevation of plasma S-100B. Thus, no evidence for subclinical neurological injury related to glutamate infusion was found. In contrast, postoperative elevation of plasma S-100B was linked to calcification of the ascending aorta and postoperative confusion.

Place, publisher, year, edition, pages
Elsevier Science B.V., Amsterdam , 2010. Vol. 29, no 3, 358-364 p.
Keyword [en]
Glutamate; Neurological injury; Nutrition; Coronary artery bypass surgery; Myocardial protection; Stroke
National Category
Nutrition and Dietetics
Identifiers
URN: urn:nbn:se:liu:diva-58272DOI: 10.1016/j.clnu.2009.09.007ISI: 000279413100013PubMedID: 19853332OAI: oai:DiVA.org:liu-58272DiVA: diva2:337942
Available from: 2010-08-10 Created: 2010-08-09 Last updated: 2017-12-12Bibliographically approved

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Holm, JonasHåkanson, ErikVánky, FarkasSvedjeholm, Rolf

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