It is unclear what role the experimental drug and convalescent plasma had in the recovery of these patients. Prospective clinical trials are needed to delineate the role of investigational therapies in the care of patients with EVD.

Background-Nosocomial infections are an important cause of morbidity and mortality in the surgical intensive care unit (SICU). Clinical benefits of glutamine-supplemented parenteral nutrition may occur in hospitalized surgical patients, but efficacy data in different surgical subgroups are lacking. The objective was to determine whether glutamine-supplemented parenteral nutrition differentially affects nosocomial infection rates in selected subgroups of SICU patients.

The incidence of various micronutrient deficiencies in critically ill patients who required CRRT was higher than previously reported. Prospective studies are needed to determine the impact of CRRT on micronutrient status and the potential clinical and metabolic efficacy of supplementation in the intensive care unit setting.

Objective To determine whether glutamine (GLN)-supplemented parenteral nutrition (PN) improves clinical outcomes in surgical ICU (SICU) patients. Summary Background Data GLN requirements may increase with critical illness. GLN-supplemented PN may improve clinical outcomes in SICU patients, but data in patient subgroups are limited. Methods A parallel-group, multicenter, double blind, randomized, controlled clinical trial in adults after gastrointestinal, vascular, or cardiac surgery who required PN and SICU care. Subjects were without significant renal or hepatic failure or shock at entry. All received isonitrogenous, isocaloric PN [1.5 g/kg/d amino acids (AA) and energy at 1.3 × estimated basal energy expenditure]. Controls (n = 75) received standard GLN-free PN (STD-PN); the GLN group (n = 75) received PN containing alanyl-GLN dipeptide (0.5 g/kg/d), proportionally replacing AA in control PN (GLN-PN). Enteral nutrition (EN) was advanced and PN weaned as indicated. Hospital mortality and infections were primary endpoints. Results Baseline characteristics, days on study PN and daily energy and amino acid/protein intakes via PN and EN were similar between groups. There were 11 hospital deaths (14.7%) in the GLN-PN group and 13 deaths in the STD-PN group and (17.3%; difference, −2.6%; 95% confidence interval −14.6 to 9.3%; P = 0.66). The 6-month cumulative all-cause mortality was 31.4% in the GLN-PN group and 29.7% in the STD-PN group (P = 0.88). Incident bloodstream infection rate was 9.6 and 8.4 per 1000 hospital days in the GLN-PN and STD-PN groups, respectively (P= 0.73). Other clinical outcomes and adverse events were similar. Conclusions PN supplemented with GLN dipeptide was safe but did not alter clinical outcomes among SICU patients.