The role of glutamine in maintaining a healthy gut and supporting the metabolic response to injury and infection.
In the critically ill surgical patient a variety of therapeutic maneuvers is required to maintain a "healthy gut." Provision of adequate amounts of glutamine to the gastrointestinal mucosa appears to be just one of these maneuvers. Other methods utilized to protect the gut from becoming a wound include: (a) minimizing additional systemic insults (such as hypotension, sepsis, multiple operative procedures); (b) aggressive pulmonary care; (c) the judicious use of antibiotics; and (d) aggressive enteral or parenteral feedings. The concept that the gut is an organ of quiescence following surgical stress merits reconsideration. The intestinal tract plays a central role in interorgan glutamine metabolism and is a key regulator of nitrogen handling following surgical stress. Critically ill patients are susceptible to developing gut-origin sepsis, the incidence of which will be diminished by instituting measures and providing treatments which support intestinal structure, function, and metabolism. Provision of glutamine-enriched diets to such patients may be one of these therapies.
Souba
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WW
Department of Surgery, University of Florida College of Medicine, Gainesville 32610.
Klimberg
V S
VS
Plumley
D A
DA
Salloum
R M
RM
Flynn
T C
TC
Bland
K I
KI
Copeland
E M
EM
D000818:Animals; D005973:Glutamine / Q000378:metabolism / Q000502:physiology*; D006801:Humans; D007239:Infections / Q000378:metabolism*; D007410:Intestinal Diseases / Q000378:metabolism*; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000293:injuries / Q000502:physiology*; D012016:Reference Values; D013312:Stress, Physiological / Q000378:metabolism; D014947:Wounds and Injuries / Q000378:metabolism
D005973:Glutamine