[Glutamine and growth hormone for the surgical nutritional support]

Characteristic responses to surgery, trauma, and sepsis are catabolism and immunodepression. Nutritional therapy is important for managing patients with severe surgical stress. Conventional nutritional support, however, has not been successful in reducing morbidity and mortality rates. New nutritional support strategies have been aimed at enhancing protein metabolism and immunity. This review focuses on glutamine and growth hormone as nutritional support strategies for patients experiencing surgical stress. Glutamine is important in several key metabolic processes in critical illness. Exogenous glutamine also augments the functions of lymphocytes, macrophages, and neutrophils. Growth hormone has potent anabolic actions. Moreover, the peptides have immunostimulatory effects. These new modalities may be beneficial for the treatment of surgical patients.