BACKGROUND: The management of acute pancreatitis (AP) frequently includes parenteral nutrition, but conditionally essential amino acids such as glutamine are not included in conventional total parenteral nutrition (TPN). AIM: This study was conducted to determine whether the inclusion of glutamine has a beneficial effect in patients with AP receiving TPN. METHODS: In a randomized, controlled study 28 patients with AP received either a standard TPN with 1.5 g/kg body weight protein or an isonitrogen, isocaloric TPN which contains 0.3 g/kgL -alanine- L -glutamine. Patients were assessed for nutritional and inflammatory parameters, infectious complications, length of TPN, length of hospital stay (LOS) and cost of TPN. RESULTS: There were no side-effects related to glutamine substitution observed. Glutamine was associated with a significant increase of cholinesterase, albumin and lymphocyte count in AP as well a decrease of C-reactive protein compared to standard TPN at day 14. There was a reduced length of TPN (10 [6-16] vs 16 [10-18] days, P<0.05) and a trend of reduced LOS (21 [14-32] vs 25 [19-40] days) in AP patients receiving glutamine. The overall cost per patient for TPN did not differ (gln+: 929+/-586 vs gln-: 981+/-507 euro/patient). CONCLUSION: Our results suggest that glutamine substitution is beneficial and does not increase the overall cost of parenteral feeding in patients with acute pancreatitis.
RCT Entities:
BACKGROUND: The management of acute pancreatitis (AP) frequently includes parenteral nutrition, but conditionally essential amino acids such as glutamine are not included in conventional total parenteral nutrition (TPN). AIM: This study was conducted to determine whether the inclusion of glutamine has a beneficial effect in patients with AP receiving TPN. METHODS: In a randomized, controlled study 28 patients with AP received either a standard TPN with 1.5 g/kg body weight protein or an isonitrogen, isocaloric TPN which contains 0.3 g/kg L -alanine- L -glutamine. Patients were assessed for nutritional and inflammatory parameters, infectious complications, length of TPN, length of hospital stay (LOS) and cost of TPN. RESULTS: There were no side-effects related to glutamine substitution observed. Glutamine was associated with a significant increase of cholinesterase, albumin and lymphocyte count in AP as well a decrease of C-reactive protein compared to standard TPN at day 14. There was a reduced length of TPN (10 [6-16] vs 16 [10-18] days, P<0.05) and a trend of reduced LOS (21 [14-32] vs 25 [19-40] days) in AP patients receiving glutamine. The overall cost per patient for TPN did not differ (gln+: 929+/-586 vs gln-: 981+/-507 euro/patient). CONCLUSION: Our results suggest that glutamine substitution is beneficial and does not increase the overall cost of parenteral feeding in patients with acute pancreatitis.
Authors: Maisam Abu-El-Haija; Soma Kumar; Jose Antonio Quiros; Keshawadhana Balakrishnan; Bradley Barth; Samuel Bitton; John F Eisses; Elsie Jazmin Foglio; Victor Fox; Denease Francis; Alvin Jay Freeman; Tanja Gonska; Amit S Grover; Sohail Z Husain; Rakesh Kumar; Sameer Lapsia; Tom Lin; Quin Y Liu; Asim Maqbool; Zachary M Sellers; Flora Szabo; Aliye Uc; Steven L Werlin; Veronique D Morinville Journal: J Pediatr Gastroenterol Nutr Date: 2018-01 Impact factor: 2.839
Authors: Concepción F Estívariz; Daniel P Griffith; Menghua Luo; Elaina E Szeszycki; Niloofar Bazargan; Nisha Dave; Nicole M Daignault; Glen F Bergman; Therese McNally; Cindy H Battey; Celeste E Furr; Li Hao; James G Ramsay; Carolyn R Accardi; George A Cotsonis; Dean P Jones; John R Galloway; Thomas R Ziegler Journal: JPEN J Parenter Enteral Nutr Date: 2008-06-09 Impact factor: 4.016