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Related Experiment Video

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Glutamine supplementation for critically ill adults.

Kun-Ming Tao1, Xiao-Qian Li, Li-Qun Yang

  • 1Department of Anesthesiology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Room 404, Building 3, Eastern Hepatobiliary Surgery Hospital, 225 Changhai Road, Shanghai, Shanghai, China, 200438.

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Glutamine supplementation may reduce infection rates and hospital stays for critically ill patients. However, it shows no significant effect on mortality and has imprecise results for side effects, with evidence quality varying.

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Area of Science:

  • Clinical Nutrition
  • Critical Care Medicine
  • Surgical Outcomes

Background:

  • Glutamine is an abundant amino acid, but levels may decrease during critical illness or major surgery.
  • Studies suggest glutamine may be conditionally essential under extreme stress.
  • Previous reviews indicated potential benefits of glutamine supplementation in critical illness, but recent trials yielded conflicting results.

Purpose of the Study:

  • To assess glutamine supplementation's effects on infection rates, mortality, and other outcomes in critically ill adults and post-major surgery patients.
  • To investigate heterogeneity across patient groups and nutritional delivery routes.

Main Methods:

  • Systematic review and meta-analysis of controlled clinical trials with random or quasi-random allocation.
  • Searched multiple databases including Cochrane, MEDLINE, EMBASE, and Web of Science.
  • Extracted data on infectious complications, mortality, length of stay, and mechanical ventilation, calculating risk ratios and mean differences.

Main Results:

  • Glutamine supplementation reduced infectious complications (RR 0.79) and length of hospital stay (MD -3.46 days) with moderate to low quality evidence.
  • No statistically significant difference was found in short-term or long-term mortality.
  • Slightly prolonged ICU stay (MD 0.18 days) and shorter mechanical ventilation duration (MD -0.69 days) were observed.

Conclusions:

  • Moderate evidence suggests glutamine supplementation reduces infection rates and mechanical ventilation days.
  • Low quality evidence indicates a reduced hospital stay, with little to no effect on mortality or ICU stay.
  • Evidence quality was limited by bias, potential publication bias, and heterogeneity.