Background. Significant nutritional support to meet increased energy expenditure is vital for burn patient's survival. Burn injury may lead to a significant decrease in Glutamine levels, which inspired the hypothesis that glutamine supplementation following burn injury would improve outcomes. Hence, the purpose of this meta-analysis study was to provide the rationale for determining the efficacy and safety of enteral glutamine in burn patients.   Methods. We conducted a meta-analysis based on PRISMA design to assess the potency of enteral glutamine supplementation as adjuvant treatment in patients with burn trauma. PubMed, Sciencedirect, and Google scholar were searched systematically using the following keywords: "enteral glutamine" and "burn patients" and "critical ill" and "infection" and "length of stay". Newcastle-Ottawa Scale (NOS) was used to assess the quality of papers included in our meta-analysis. A Z test was used to determine the significance of pooled effect estimates. Publication bias was assessed using Egger's. We used Comprehensive Meta-Analysis (CMA) version 2.1 to analyze the data.   Results: A total of 12 studies recording 344 cases and 335 controls were enrolled for our analysis. Data on hospital Length of Stay (LOS) was found that enteral glutamine supplementation provided a significant result in reducing the LOS (Std mean diff: 0.70, 95%CI: 0.16 – 1.24; p=0.0100). We also found that a higher risk of positive wound culture was significantly observed in patients without the supplementation of enteral glutamine (OR 2.15, 95% CI: 1.41 – 3.27; p=0.0003) compared to patients receiving enteral glutamine supplementation among burn patients.   Conclusion: In our meta-analysis study, enteral glutamine in burn patients confers significantly shorter LOS and lower risk of wound infection among burn patients. We suggest that enteral glutamine supplementation may be a beneficial intervention for the management of burn patients.

In critically ill patients, marked protein catabolism is prevalent. Protein demanding for such patients has been based on commending nitrogen balance, in most cases. Due to the stress response, critically ill patients tend to fall into a negative nitrogen balance state. Metabolic changes, particularly in elderly critically ill patients, increase the risk of the worsening nitrogen balance. Some evidence suggested optimal nitrogen balance may not indeed equalize to the best clinical outcome. On the contrary, several studies reported the available nitrogen balance data in establishing new recommendations for the protein required by critically ill patients. There is a hypothesis that adequate protein supplementation utilizing nitrogen balance could be correlated with improved results for patients in intensive care unit (ICU). Therefore, this literature review aims to deliver a brief explanation of whether nitrogen balance can be useful in documenting the effectiveness of nutritional therapy in critical illness or not.

Background: Assessment of nutrition status of newly hospitalized patients is an initial stage of nutrition intervention which will bring effects to the duration of stay and the history of patients' diseases during hospitalization. Appropriate nutrition intervention as part of  patients' care can be used as an indicator of the quality of hospital service.Objective: The study aimed to identify preliminary nutrition status of newly hospitalized adult patients using SGA method, its effects to length of stay and status of discharge and compare the capacity of SGA and NSSA indicators in predicting length of stay and status of discharge of adult patients.Method: This observational study used prospective cohort study design. It was carried out at Anuntaloko Hospital of Parigi, District of Parigi Moutong, Sulawesi Tengah from July to September 2008. Subject consisted of 162 people comprising 82 undernourished people and 80 people with good nutrition status based on assessment using SGA method. Data analysis used bivariable and multivariable, receiver operating characteristics (ROC) curve and diagnostic methods using computer program.Result: The majority of newly hospitalized patients were undernourished (50.6%); preliminary status of patients assessed using SGA method could affect length of stay, relative risk (RR)=3.67 but not status of discharge (RR=0.97). The capacity of SGA indicator, area under the curve (AUC)=0.81 and maximum sum of sensitivity and specifcity (MSS) =1.57 was better than NSSA indicator (AUC=0.76 and MSS 1.43) in predicting length of stay. The capacity of SGA indicator (AUC=0.50 and MSS=1.01) was better than NSSA indicator (AUC=0.49 and MSS=0.98) in predicting discharge status of the patient.Conclusion: SGA and NSSA indicators could be implemented in assessing preliminary nutrition status of newly hospitalized adult patients; SGA indicator had better capacity than NSSA indicator.