Enteral/Oral Glutamine Supplementation in Patients Following Surgery and Accidental Injury

John, Meha Rachel; M, Vijey Aanandhi

doi:10.22159/ajpcr.2017.v10i3.16569

Cited by 3 publications

(2 citation statements)

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“…In burned patients, there may be a benefit reducing mortality and infectious morbidity, but data are scarce, and broader studies are warranted to confirm this effect [32]. John and Aanandhi, in their study, have concluded that the supplementation of enteral glutamine in post-operative patients decreases the incidence of post-surgical infection, shortening of hospital stay, and reduction in the overall hospital costs which were similar to our study [33]. Oktavia et al in a review of many studies in critically ill adults suggested that glutamine-supplemented amino acid solutions may reduce mortality, improve nitrogen balance, and reduce the incidence of clinical infection [34].…”

Section: Discussionsupporting

confidence: 85%

Immunonutrition With Glutamine in Icu Patients

Das

Routray²,

Pradhan³

et al. 2017

Asian J Pharm Clin Res

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Objective: Endogenous production of glutamine may be reduced during critical illness. The shortage of glutamine is reflected as a decrease in plasma concentration, which is a prognostic factor for outcome in sepsis. Therefore, we have studied the effect of enteral or parenteral glutamine therapy on biochemical parameters and the hospital stay of critically ill patients.Methods: A total of 66 critically ill patients aged 18-70 years, admitted to central and medical intensive care unit of a tertiary care hospital were randomly divided into three equal groups; 22 in each group: Group 1 (control group) received no glutamine, Group 2 received oral glutamine 0.5 g/kg/d for 5 days, and Group 3 received parenteral glutamine 0.5 g/kg/d by intravenous infusion for 5 days. All patients received glutamine-free tube feed throughout the study period. Total leukocyte count (TLC), total lymphocyte count, total protein and serum albumin, serum lactate, and sequential organ failure assessment (SOFA) score were recorded on each day for 7 days and were compared.Results: Decrease in the TLC and increase in lymphocyte count was most evident in Group 3 compared to Groups 2 and 1 which was statistically significant. Decrease in serum lactate and increase in serum protein and albumin was maximum in Group 3 compared to Groups 1 and 2 which was statistically significant. The mean duration of hospital stay of Group 3 was the least followed by Groups 2 and 1 which was statistically not significant. There was an improvement in SOFA score in all the three groups.Conclusion: Parenteral glutamine in a dose of 0.5 g/kg/d was more potent than oral glutamine in improving the biochemical parameters. The duration of hospital stay was similar in all the groups after treatment.

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Section: Discussionsupporting

confidence: 85%

Immunonutrition With Glutamine in Icu Patients

Das

Routray²,

Pradhan³

et al. 2017

Asian J Pharm Clin Res

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“…12, 19-20 Some authors reported that supplementation of enteral or parenteral glutamine showed improved immune function, reduced infections, and shortened the length of ICU stay. [29][30][31] Day 1 SOFA score is an indicator of the severity of illness. The decrease in SOFA score was statistically significant in the two groups.…”

Section: Discussionmentioning

confidence: 99%

A randomized, controlled study to evaluate the effect of parenteral glutamine on the reduction of infection related morbidity in burn patients in ICU

Eskandr¹,

Attalla²,

Massoud³

et al. 2022

Anaesth. pain intensive care

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Background: Burn patients are characterized by alterations within the immune system, increased exposure to infectious complications, sepsis, and potentially organ failure and death. Glutamine supplementation to parenteral nutrition has been proven to be related to improved clinical outcomes in trauma patients. We studied the effect of glutamine supplementation on infection and clinical outcomes among burn patients. Methodology: Sixty burn patients were randomly divided into two equal groups. Group I received 0.5 gm/kg/day glutamine infusion as a part of parenteral nutrition for seven days after ICU admission. Group II received an intravenous placebo by continuous infusion (24 h/day). The primary outcome was the presence of infection assessed by the wound culture over a 15-days period. The secondary outcomes were: blood culture, WBCs count, serum C-reactive protein (CRP) and procalcitonin, sequential organ failure assessment (SOFA) score, and length of stay within the intensive care unit. Results: The results showed that the incidence of positive wound culture was considerably reduced within the glutamine group, e.g., 6 (10%) patients) vs. control 19 (33%) patients; P < 0.001). The incidence of positive blood culture was significantly reduced within the study group (1 case) vs. control (9 cases; P = 0.006). In addition, the WBC, serum CRP and procalcitonin were better; and the SOFA score and the ICU-stay were reduced within the glutamine group vs. the control group. Conclusion: The present results prove that IV glutamine supplementation in adult burn patients can reduce the impact of infectious morbidity and improve the clinical outcome. Ethical committee approval: 19/5/2019 ANETS 4 Trial registration: www.clinicaltrials.gov No. NCT05140772 Abbreviations: ICU - intensive care unit; SOFA - Sequential Organ Failure Assessment; CRP - C-reactive protein; GFR- glomerular filtration rate; TBSA - total body surface area; BMI – Body mass index Key words: Glutamine; Infection; Burn; ICU; Mortality Citation: Eskandr AM, Attalla HA, Massoud ME, Alaa-Eldin A. Aiad AEA. A randomized, controlled study to evaluate the effect of parenteral glutamine on the reduction of infection related morbidity in burn patients in ICU. Anaesth. pain intensive care 2022;26(2):318-325; DOI: 10.35975/apic.v26i3.1898 Received: December 24. 2021, Reviewed: January 18, 2022, Accepted: January 29, 2022

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