Parenteral glutamine supply in intensive care patients

Glutamine, an abundant amino acid, has many metabolic roles that protect tissue integrity and enhance the immune system. Low plasma and tissue levels of glutamine in the critically-ill suggest that demand may exceed endogenous supply and with the profound muscle wasting that occurs this supply of glutamine may become critical to survival. The very sickest patients who are unable to tolerate enteral feeding are solely dependent on conventional parenteral nutrition which does not contain glutamine. This short review, drawing upon a recent double blind randomised clinical six month outcome study, provides the rationale to suggest that parenteral glutamine supply in these very sick patients may improve recovery and reduce late mortality.