Objectives:Animal studies have shown that the elevation of plasma glutamate levels increase cerebral edema formation whenever the blood-brain barrier is disturbed. Therefore, changes in plasma glutamate levels as influenced by the administration of a glutamate-containing amino acid solution were investigated in neurosurgical patients.Design:Prospective, descriptive study.Setting:Eight-bed neurosurgical intensive care unit in a university hospital.Patients:Twenty-three neurosurgical patients requiring parenteral nutrition.Interventions:Parenteral nutrition was begun 24 hrs after craniotomy. Patients receiving a glutamate-containing amino acid solution (3.75 g/L glutamate) were compared with patients infused with a glutamate-free solution.Measurements and Main Results:Arterial plasma and urine amino acids were analyzed using high-performance liquid chromatography. Administration of a glutamate-containing solution doubled plasma glutamate levels in neurosurgical patients (from 53.3 ± 9.8 μM [preinfusion] to 98.5 ± 18.7 μM [after 4 hrs of infusion];p< 0.001), whereas no elevation was seen when infusing a glutamate-free solution (from 52.3 ± 7.3 [1 hr of infusion] to 53.6 ± 6.4 μM [4 hrs of infusion]). Upon terminating the glutamate-containing infusion, arterial plasma glutamate levels decreased immediately (from 120 ± 13.2 μM to 81.2 ± 19.5 μM). Glutamate as infused in excess appears to exceed a renal threshold and is eliminated renally.Conclusions:As shown in animal models, administration of a glutamate-containing amino acid solution significantly increased plasma glutamate levels. Because such an increase in plasma glutamate levels could aggravate cerebral edema formation, glutamate-containing amino acid solutions cannot be recommended for patients with a disturbed blood-brain barrier.