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Glutamine Flux Imaging Using Genetically Encoded Sensors
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Glutamine supplementation.

Jan Wernerman1

  • 1Department of Intensive Care Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden. jan.wernerman@karolinska.se.

Annals of Intensive Care
|September 13, 2011
PubMed
Summary
This summary is machine-generated.

Intravenous glutamine supplementation is standard for critically ill patients receiving parenteral nutrition, potentially reducing mortality. However, evidence is insufficient to recommend enteral glutamine for most critically ill patients.

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Area of Science:

  • Clinical Nutrition
  • Metabolic Regulation
  • Critical Care Medicine

Background:

  • Intravenous glutamine is standard for parenteral nutrition in critical illness, with data suggesting reduced mortality.
  • Standard parenteral nutrition products lack glutamine due to instability; enteral nutrition contains insufficient amounts to normalize plasma levels.
  • Low plasma glutamine concentration is a significant independent risk factor for mortality in critically ill patients.

Purpose of the Study:

  • To review the current evidence on glutamine supplementation in critically ill patients.
  • To discuss the role of glutamine in critical illness and the regulation of its endogenous production.
  • To identify knowledge gaps for future glutamine supplementation guidelines.

Main Methods:

  • Literature review of studies on glutamine supplementation in critical illness.
  • Analysis of glutamine's role in cellular metabolism and endogenous production.
  • Discussion of plasma glutamine levels as a biomarker.

Main Results:

  • Intravenous glutamine is beneficial in parenteral nutrition, but evidence for enteral supplementation is insufficient.
  • Enteral nutrition formulations contain low glutamine doses (2-4 g/L), inadequate for normalizing plasma concentrations.
  • Skeletal muscle is a major glutamine producer, contributing to muscle depletion in critical illness.

Conclusions:

  • Further research into the regulation of endogenous glutamine production is needed.
  • Optimizing glutamine supplementation strategies requires a better understanding of its metabolic roles.
  • Current evidence does not support routine enteral glutamine supplementation for critically ill patients.