Glutamine in the ICU: who needs supply?

Area of Science:

• Biochemistry
• Critical Care Medicine
• Nutritional Science

Background:

• Intensive care unit (ICU) patients often exhibit glutamine depletion, with low plasma concentrations.
• Glutamine supplementation has demonstrated beneficial effects in specific patient populations within the ICU.

Discussion:

• Elevated glutamine plasma concentrations are observed in certain conditions, notably acute right heart failure.
• In these specific cases, exogenous glutamine administration may pose a risk, potentially leading to a toxic burden.

Key Insights:

• Glutamine status (depleted vs. elevated) is critical for determining appropriate supplementation in ICU patients.
• The potential for glutamine toxicity must be considered, particularly in patients with right heart failure or unresolved shock.

Outlook:

• Re-evaluation of current glutamine supplementation protocols in ICUs is recommended.
• Further research is needed to define precise indications and contraindications for glutamine therapy in critical illness, especially concerning hemodynamic instability.