Glutamine in critical care - current evidence from systematic reviews

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Glutamine, the most abundant amino acid in the body, is thought to become conditionally essential in critical illness. Some of the important roles for glutamine are as a carrier for inter-organ N, a preferred fuel for enterocytes and cells of the immune system, a substrate for renal NH3 formation and a precursor for glutathione. Mechanisms by which glutamine could improve recovery include attenuating oxidant damage and inflammatory cytokine production, reducing gut bacterial translocation and improving N balance. The present systematic review has found trends to suggest that parenteral and enteral glutamine supplementation reduce mortality, the development of infection and organ failure in critical illness. Trials of parenteral nutrition containing glutamine with patients after elective surgery also suggest reduction of infection, but it is unlikely that glutamine-containing parenteral nutrition would be used for such patients. The evidence base is limited by the quality of the reported trials and the suggestion that there is publication bias, with trials suggesting reduced infection being more likely to be published.

Original languageEnglish
Pages (from-to)236-241
Number of pages5
JournalProceedings of the Nutrition Society
Volume65
DOIs
Publication statusPublished - 2006

Keywords

  • glutamine
  • randomised controlled trials
  • systematic reviews
  • meta-analyses
  • critical illness
  • TOTAL PARENTERAL-NUTRITION
  • PROSPECTIVE RANDOMIZED-TRIAL
  • MAJOR ABDOMINAL-SURGERY
  • ILL PATIENTS
  • INFECTIOUS MORBIDITY
  • ENTERAL NUTRITION
  • DOUBLE-BLIND
  • INTESTINAL PERMEABILITY
  • ACUTE-PANCREATITIS
  • SURGICAL-PATIENTS

Cite this

Glutamine in critical care - current evidence from systematic reviews. / Avenell, Alison.

In: Proceedings of the Nutrition Society, Vol. 65, 2006, p. 236-241.

Research output: Contribution to journalArticle

@article{5f98007e4e9b4b15a3ae2868183c20b8,
title = "Glutamine in critical care - current evidence from systematic reviews",
abstract = "Glutamine, the most abundant amino acid in the body, is thought to become conditionally essential in critical illness. Some of the important roles for glutamine are as a carrier for inter-organ N, a preferred fuel for enterocytes and cells of the immune system, a substrate for renal NH3 formation and a precursor for glutathione. Mechanisms by which glutamine could improve recovery include attenuating oxidant damage and inflammatory cytokine production, reducing gut bacterial translocation and improving N balance. The present systematic review has found trends to suggest that parenteral and enteral glutamine supplementation reduce mortality, the development of infection and organ failure in critical illness. Trials of parenteral nutrition containing glutamine with patients after elective surgery also suggest reduction of infection, but it is unlikely that glutamine-containing parenteral nutrition would be used for such patients. The evidence base is limited by the quality of the reported trials and the suggestion that there is publication bias, with trials suggesting reduced infection being more likely to be published.",
keywords = "glutamine, randomised controlled trials, systematic reviews, meta-analyses, critical illness, TOTAL PARENTERAL-NUTRITION, PROSPECTIVE RANDOMIZED-TRIAL, MAJOR ABDOMINAL-SURGERY, ILL PATIENTS, INFECTIOUS MORBIDITY, ENTERAL NUTRITION, DOUBLE-BLIND, INTESTINAL PERMEABILITY, ACUTE-PANCREATITIS, SURGICAL-PATIENTS",
author = "Alison Avenell",
year = "2006",
doi = "10.1079/PNS2006498",
language = "English",
volume = "65",
pages = "236--241",
journal = "Proceedings of the Nutrition Society",
issn = "0029-6651",
publisher = "Cambridge Univ. Press.",

}

TY - JOUR

T1 - Glutamine in critical care - current evidence from systematic reviews

AU - Avenell, Alison

PY - 2006

Y1 - 2006

N2 - Glutamine, the most abundant amino acid in the body, is thought to become conditionally essential in critical illness. Some of the important roles for glutamine are as a carrier for inter-organ N, a preferred fuel for enterocytes and cells of the immune system, a substrate for renal NH3 formation and a precursor for glutathione. Mechanisms by which glutamine could improve recovery include attenuating oxidant damage and inflammatory cytokine production, reducing gut bacterial translocation and improving N balance. The present systematic review has found trends to suggest that parenteral and enteral glutamine supplementation reduce mortality, the development of infection and organ failure in critical illness. Trials of parenteral nutrition containing glutamine with patients after elective surgery also suggest reduction of infection, but it is unlikely that glutamine-containing parenteral nutrition would be used for such patients. The evidence base is limited by the quality of the reported trials and the suggestion that there is publication bias, with trials suggesting reduced infection being more likely to be published.

AB - Glutamine, the most abundant amino acid in the body, is thought to become conditionally essential in critical illness. Some of the important roles for glutamine are as a carrier for inter-organ N, a preferred fuel for enterocytes and cells of the immune system, a substrate for renal NH3 formation and a precursor for glutathione. Mechanisms by which glutamine could improve recovery include attenuating oxidant damage and inflammatory cytokine production, reducing gut bacterial translocation and improving N balance. The present systematic review has found trends to suggest that parenteral and enteral glutamine supplementation reduce mortality, the development of infection and organ failure in critical illness. Trials of parenteral nutrition containing glutamine with patients after elective surgery also suggest reduction of infection, but it is unlikely that glutamine-containing parenteral nutrition would be used for such patients. The evidence base is limited by the quality of the reported trials and the suggestion that there is publication bias, with trials suggesting reduced infection being more likely to be published.

KW - glutamine

KW - randomised controlled trials

KW - systematic reviews

KW - meta-analyses

KW - critical illness

KW - TOTAL PARENTERAL-NUTRITION

KW - PROSPECTIVE RANDOMIZED-TRIAL

KW - MAJOR ABDOMINAL-SURGERY

KW - ILL PATIENTS

KW - INFECTIOUS MORBIDITY

KW - ENTERAL NUTRITION

KW - DOUBLE-BLIND

KW - INTESTINAL PERMEABILITY

KW - ACUTE-PANCREATITIS

KW - SURGICAL-PATIENTS

U2 - 10.1079/PNS2006498

DO - 10.1079/PNS2006498

M3 - Article

VL - 65

SP - 236

EP - 241

JO - Proceedings of the Nutrition Society

JF - Proceedings of the Nutrition Society

SN - 0029-6651

ER -