Methionine Metabolism in Parenterally Fed Pediatric Sepsis
Completed
Conditions studied: Sepsis, Critical Illness
In brief
Critically ill children have abnormal utilization of nutrients such as glucose, lipids and protein. Protein synthesis is increased mainly in the form of immune and signaling proteins, while synthesis of muscle and structural proteins is decreased. The metabolism of sulfur amino acids and specifically methionine and cysteine have not been investigated in critically ill septic children, despite that sulfur amino acids have important roles on thiol, antioxidant and epigenetic reactions, as well as precursor of glutathione (GSH). Methionine metabolism in critically ill children will be influenced by its rate of utilization through the transmethylation, remethylation and transsulfuration pathways, which are the major pathways of methionine metabolism. The investigators study aims to investigate the metabolism of methionine and cysteine in parenterally fed critically ill septic children. The investigators aim to determine the rates of transmethylation, remethylation, transsulfuration and GSH synthesis rates in critically ill septic children, to determine in vivo, whole body sulfur amino acid metabolism when sulfur amino acids are supplied by the parenteral route. The objective is to determine whether current parenteral intakes support GSH synthesis and if methionine metabolism differs when supplied by the parenteral versus the enteral route. Methionine parenteral requirements will be also studied by using the indicator amino acid oxidation and balance technique.
Key facts
- Study ID
- NCT01891682
- Run by
- The Cleveland Clinic
- People needed
- 45
- Starts
- 2012-10-01
- Expected to finish
- 2016-10-01
- Last updated by the study team
- 2017-03-22
Who can join
Age: 0 and older, up to 19. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Age 1 month-19 years
- Diagnosis of severe sepsis diagnosed as clinical sepsis syndrome (requires two of the following criteria):
- Source of infection
- Fever or Hypothermia
- Leukocytosis or Leucopenia
- Poor organ perfusion (such as delayed capillary refill or decreased urine output or hypotension)
- Bacteremic sepsis demonstrated by positive blood culture
- Weight greater or equal to 4 kg
- Need for parenteral nutrition
- Presence of central and/or arterial venous access as per clinical indication
You may not qualify if…
- Patients with metabolic diseases (i.e. Insulin dependent diabetes mellitus, urea cycle disorders, cystinuria, etc.)
- Pregnancy
- Primary liver failure
- Primary renal failure
- Patients on enteral feedings greater than 20% of daily requirement
- Weight less than 4.0 kg
Where it is running
- Cleveland Clinic — Cleveland, Ohio, United States
Full record on ClinicalTrials.gov
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