BACKGROUND: During critical illness, the demand for glutamine may exceed that which can be mobilized from muscle stores. Infections increase mortality, morbidity, length-of-stay, antibiotic usage and the cost of care. This is a major health care issue. METHODS: RCTs were identified from the electronic databases: the Cochrane Library, MEDLINE, PubMed web of knowledge and hand searching journals. The trials compared the supplementation with glutamine and non-supplementation in burn. Statistical analysis was performed using RevMan5.1 software, from Cochrane Collaboration. RESULTS: 216 papers showed a match, in the keyword search. Upon screening the title, reading the abstract and the entire article, only four RCTs, involving 155 patients, were included. For both the glutamine group and control group, total burn surface area (TBSA) (MD=2.02, 95% CI -2.17, 6.21, p=0.34) was similar. Glutamine supplementation was associated with a statistically significant decrease in the number of patients with gram-negative bacteremia (OR 0.27, 95% CI 0.08-0.92, p=0.04) and hospital mortality (OR=0.13, 95% CI 0.03, 0.51, p=0.004), however, no statistical difference was noted between groups, for the other results. CONCLUSION: Glutamine supplemented nutrition can be associated with a reduction in mortality in hospital, complications due to gram-negative bacteremia in burn patients. Further larger and better quality trials are required, in order to determine whether any differences are statistically and clinically important.
BACKGROUND: During critical illness, the demand for glutamine may exceed that which can be mobilized from muscle stores. Infections increase mortality, morbidity, length-of-stay, antibiotic usage and the cost of care. This is a major health care issue. METHODS: RCTs were identified from the electronic databases: the Cochrane Library, MEDLINE, PubMed web of knowledge and hand searching journals. The trials compared the supplementation with glutamine and non-supplementation in burn. Statistical analysis was performed using RevMan5.1 software, from Cochrane Collaboration. RESULTS: 216 papers showed a match, in the keyword search. Upon screening the title, reading the abstract and the entire article, only four RCTs, involving 155 patients, were included. For both the glutamine group and control group, total burn surface area (TBSA) (MD=2.02, 95% CI -2.17, 6.21, p=0.34) was similar. Glutamine supplementation was associated with a statistically significant decrease in the number of patients with gram-negative bacteremia (OR 0.27, 95% CI 0.08-0.92, p=0.04) and hospital mortality (OR=0.13, 95% CI 0.03, 0.51, p=0.004), however, no statistical difference was noted between groups, for the other results. CONCLUSION:Glutamine supplemented nutrition can be associated with a reduction in mortality in hospital, complications due to gram-negative bacteremia in burn patients. Further larger and better quality trials are required, in order to determine whether any differences are statistically and clinically important.
Authors: Lisa Gould; Peter Abadir; Harold Brem; Marissa Carter; Teresa Conner-Kerr; Jeff Davidson; Luisa DiPietro; Vincent Falanga; Caroline Fife; Sue Gardner; Elizabeth Grice; John Harmon; William R Hazzard; Kevin P High; Pamela Houghton; Nasreen Jacobson; Robert S Kirsner; Elizabeth J Kovacs; David Margolis; Frances McFarland Horne; May J Reed; Dennis H Sullivan; Stephen Thom; Marjana Tomic-Canic; Jeremy Walston; Jo Anne Whitney; John Williams; Susan Zieman; Kenneth Schmader Journal: J Am Geriatr Soc Date: 2015-03-06 Impact factor: 5.562
Authors: Christian Sommerhalder; Elizabeth Blears; Andrew J Murton; Craig Porter; Celeste Finnerty; David N Herndon Journal: Curr Probl Surg Date: 2019-11-11 Impact factor: 1.909
Authors: Lisa Gould; Peter Abadir; Harold Brem; Marissa Carter; Teresa Conner-Kerr; Jeff Davidson; Luisa DiPietro; Vincent Falanga; Caroline Fife; Sue Gardner; Elizabeth Grice; John Harmon; William R Hazzard; Kevin P High; Pamela Houghton; Nasreen Jacobson; Robert S Kirsner; Elizabeth J Kovacs; David Margolis; Frances McFarland Horne; May J Reed; Dennis H Sullivan; Stephen Thom; Marjana Tomic-Canic; Jeremy Walston; JoAnne Whitney; John Williams; Susan Zieman; Kenneth Schmader Journal: Wound Repair Regen Date: 2015-02-13 Impact factor: 3.617