Glutamine supplementation for critically ill adults

Tao, Kun‐Ming; Li, Xiaoqian; Yang, Li‐Qun; Yu, Weifeng; Lu, Zhijie; Sun, Yuming; Wu, Feixiang

doi:10.1002/14651858.cd010050.pub2

Cited by 70 publications

(52 citation statements)

References 96 publications

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“…Its use in the form of supplementation is relevant in patients experiencing polytrauma who are hospitalized in the intensive care unit and patients with cancer and other enteral tract disorders. The results confirm in rats that the study of the use of glutamine 17 can be expanded to dentistry. The most interesting finding was the observation that the group with oral supplementation avoided the progression of periodontitis.…”

Section: Discussionsupporting

confidence: 73%

Effect of glutamine ingestion on the progression of induced periodontitis: experimental study in rats

Silva

Segundo

Semenoff

et al. 2018

Rev. odontol. UNESP

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ResumoIntrodução: Com a suplementação de glutamina há um melhor desempenho no sistema de defesa do corpo. Objetivo: O objetivo deste estudo foi analisar o efeito da suplementação de glutamina na doença periodontal induzida por ligatura em ratos. Material e método: Foram selecionados 48 ratos machos da linhagem Wistar divididos em 4 grupos (N = 12): grupo controle (GC) incluindo animais saudaveis recebendo solução salina diariamente via gavagem; grupo glutamina (GG) incluindo animais saudaveis que receberam suplementação oral de glutamina por gavagem a uma dose de 1,5 g/kg/dia; grupo periodontite (GP) incluindo animais com doença periodontal induzida na maxila em ambos os lados recebendo solução salina diária via gavagem; grupo experimental (GE) incluindo animais com doença periodontal induzida na maxila nos dois lados recebendo glutamina diária via gavagem na dose de 1,5 g/kg/dia. No 30º dia, todos os animais foram eutanasiados por excesso de anestésico. Descritores: Suplementos nutricionais; doenças periodontais; produtos com ação antimicrobiana. AbstractIntroduction: With glutamine supplementation there is better performance in the body's defense system. Objective: The aim of this study was to analyze the effect of glutamine supplementation on ligand-induced periodontal disease in rats. Material and method: 48 selected male Wistar rats were divided into 4 groups (N = 12): control group (CG) including healthy animals receiving daily saline solution via gavage; glutamine group (GG) including healthy animals receiving oral glutamine supplementation by gavage at a dose of 1.5 g / kg / day; periodontitis group (PG) including animals with induced periodontal disease on both upper sides receiving daily saline solution via gavage; experimental group (EG) including animals with induced periodontal disease on both upper sides receiving daily glutamine via gavage at a dose of 1.5 g / kg / day. On the 30th day, all animals were euthanized by excess anesthetic.

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Section: Discussionsupporting

confidence: 73%

Effect of glutamine ingestion on the progression of induced periodontitis: experimental study in rats

Silva

Segundo

Semenoff

et al. 2018

Rev. odontol. UNESP

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“…Most RCTs have not focused on specific types of critically ill medical or surgical patients; thus, characteristics of those who may benefit (and the effective GLN dose) remain an area of uncertainty (26–30). This is reflected in the results of several meta-analyses on efficacy of GLN-supplemented PN in critical illness, which often have shown improved specific clinical outcome parameters, but with trial heterogeneity and data uncertainty (31–35). …”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Glutamine-supplemented Parenteral Nutrition in Surgical ICU Patients

et al. 2016

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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.

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“…However, in the latest meta-analysis published by the Cochrane Database of Systematic Reviews, signals for mortality reduction were lost and only moderate- and low-level evidence on reduction of morbidity was found, with high risk of overall bias, suspected publication bias and moderate to substantial heterogeneity within the included studies [12]. …”

Section: Introductionmentioning

confidence: 99%

Enteral glutamine supplementation in critically ill patients: a systematic review and meta-analysis

et al. 2015

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IntroductionGlutamine (GLN) has been suggested to have a beneficial influence on outcomes of critically ill patients. However, recent large-scale trials have suggested harm associated with GLN supplementation. Recently, systematic reviews on the use of parenteral GLN have been published; however, less information is available on the role of enteral GLN. Therefore, the aim of this systematic review was to study the effects of enteral GLN supplementation in patients with critical illness.MethodsWe identified randomized controlled trials conducted from 1980 to 2014 with enterally administered GLN in adult critically ill patients. Studies of parenteral GLN only or combined enteral-parenteral GLN were excluded. The methodological quality of studies was scored, and trial data were statistically combined. We examined a priori the treatment effects in subgroups of trials of burn and trauma patients.ResultsA total of 11 studies involving 1079 adult critically ill patients and enteral GLN supplementation were identified. Enteral GLN supplementation was not associated with a reduction of hospital mortality (risk ratio [RR] 0.94, 95 % confidence interval [CI] 0.65–1.36; p =0.74), infectious complications (RR 0.93, 95 % CI 0.79–1.10; p =0.39) or stay in the intensive care unit (weighted mean difference [WMD] −1.36 days, 95 % CI −5.51 to 2.78; p =0.52). However, there was a significant reduction in hospital stay (WMD 4.73 days, 95 % CI −8.53 to −0.90; p =0.02). In the subset of studies of patients with burns, enteral GLN supplementation was associated with significant reductions in hospital mortality (RR 0.19, 95 % 0.06–0.67; p =0.010) and hospital stay (WMD −9.16, 95 % CI −15.06 to −3.26; p =0.002). There was no effect in trauma patients.ConclusionsEnteral GLN supplementation does not confer significant clinical benefit in critically ill patients, with the exception of reduced hospital stay. There may be a significant benefit in patients with burns, but data are sparse and larger randomized trials are warranted to confirm this effect.

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Glutamine supplementation for critically ill adults

Cited by 70 publications

References 96 publications

Effect of glutamine ingestion on the progression of induced periodontitis: experimental study in rats

Effect of glutamine ingestion on the progression of induced periodontitis: experimental study in rats

Efficacy and Safety of Glutamine-supplemented Parenteral Nutrition in Surgical ICU Patients

Enteral glutamine supplementation in critically ill patients: a systematic review and meta-analysis

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