BACKGROUND:Glutamine depletion has negative effects on the functional integrity of the gut and leads to immunosuppression. Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion because nutrition is limited in the first weeks of life. OBJECTIVE: The objective was to determine the effect of glutamine-enriched enteral nutrition on feeding tolerance, infectious morbidity, and short-term outcome in VLBW infants. DESIGN: In a double-blind randomized controlled trial, VLBWinfants (gestational age <32 wk or birth weight <1500 g) were allocated to receive enteral glutamine supplementation (0.3 g . kg(-1) . d(-1)) or isonitrogenous control supplementation (alanine) between days 3 and 30 of life. The supplementations were added to breast milk or to preterm formula. The primary endpoint for the study was time to full enteral feeding. Secondary endpoints were other variables of feeding tolerance, infectious morbidity, and short-term outcome. RESULTS: Baseline patient and nutritional characteristics were not significantly different in the glutamine-supplemented (n = 52) and the control (n = 50) groups. The median time to full enteral feeding was 13 d (range: 7-31 d) in the glutamine-supplemented group and 13 d (range: 6-35 d) in the control group (hazard ratio: 1.19; 95% CI: 0.79, 1.79; P = 0.40). In the glutamine-supplemented group, 26 of 52 infants (50%) had >/=1 serious infection compared with 38 of 50 (76%) in the control group (odds ratio: 0.32; 95% CI: 0.14, 0.74; P = 0.008). Other variables of feeding tolerance and short-term outcome were not significantly different between groups. CONCLUSIONS:Glutamine-enriched enteral nutrition did not improve feeding tolerance or short-term outcome in VLBW infants. However, infectious morbidity was significantly lowered in infants who received glutamine-enriched enteral nutrition.
RCT Entities:
BACKGROUND:Glutamine depletion has negative effects on the functional integrity of the gut and leads to immunosuppression. Very-low-birth-weight (VLBW) infants are susceptible to glutamine depletion because nutrition is limited in the first weeks of life. OBJECTIVE: The objective was to determine the effect of glutamine-enriched enteral nutrition on feeding tolerance, infectious morbidity, and short-term outcome in VLBW infants. DESIGN: In a double-blind randomized controlled trial, VLBW infants (gestational age <32 wk or birth weight <1500 g) were allocated to receive enteral glutamine supplementation (0.3 g . kg(-1) . d(-1)) or isonitrogenous control supplementation (alanine) between days 3 and 30 of life. The supplementations were added to breast milk or to preterm formula. The primary endpoint for the study was time to full enteral feeding. Secondary endpoints were other variables of feeding tolerance, infectious morbidity, and short-term outcome. RESULTS: Baseline patient and nutritional characteristics were not significantly different in the glutamine-supplemented (n = 52) and the control (n = 50) groups. The median time to full enteral feeding was 13 d (range: 7-31 d) in the glutamine-supplemented group and 13 d (range: 6-35 d) in the control group (hazard ratio: 1.19; 95% CI: 0.79, 1.79; P = 0.40). In the glutamine-supplemented group, 26 of 52 infants (50%) had >/=1 serious infection compared with 38 of 50 (76%) in the control group (odds ratio: 0.32; 95% CI: 0.14, 0.74; P = 0.008). Other variables of feeding tolerance and short-term outcome were not significantly different between groups. CONCLUSIONS:Glutamine-enriched enteral nutrition did not improve feeding tolerance or short-term outcome in VLBW infants. However, infectious morbidity was significantly lowered in infants who received glutamine-enriched enteral nutrition.
Authors: Joseph Carcillo; Richard Holubkov; J Michael Dean; John Berger; Kathleen L Meert; K J S Anand; Jerry Zimmerman; Christopher J L Newth; Rick Harrison; Douglas F Willson; Carol Nicholson Journal: JPEN J Parenter Enteral Nutr Date: 2009-04-14 Impact factor: 4.016
Authors: Joseph A Carcillo; J Michael Dean; Richard Holubkov; John Berger; Kathleen L Meert; K J S Anand; Jerry Zimmerman; Christopher J L Newth; Rick Harrison; Jeri Burr; Douglas F Willson; Carol Nicholson Journal: Pediatr Crit Care Med Date: 2012-03 Impact factor: 3.624
Authors: Douglas F Willson; J Michael Dean; Kathleen L Meert; Christopher J L Newth; Kanwaljeet J S Anand; John Berger; Rick Harrison; Jerry Zimmerman; Joseph Carcillo; Murray Pollack; Richard Holubkov; Tammara L Jenkins; Carol Nicholson Journal: Pediatr Crit Care Med Date: 2010-01 Impact factor: 3.624
Authors: Joseph A Carcillo; J Michael Dean; Richard Holubkov; John Berger; Kathleen L Meert; Kanwaljeet J S Anand; Jerry J Zimmerman; Christopher J L Newth; Rick Harrison; Jeri Burr; Douglas F Willson; Carol Nicholson; Michael J Bell; Robert A Berg; Thomas P Shanley; Sabrina M Heidemann; Heidi Dalton; Tammara L Jenkins; Allan Doctor; Angie Webster; Robert F Tamburro Journal: JPEN J Parenter Enteral Nutr Date: 2016-09-22 Impact factor: 4.016
Authors: Joris H J van Sadelhoff; Linda P Siziba; Lisa Buchenauer; Marko Mank; Selma P Wiertsema; Astrid Hogenkamp; Bernd Stahl; Johan Garssen; Dietrich Rothenbacher; Jon Genuneit Journal: Nutrients Date: 2021-06-10 Impact factor: 5.717