Cost containment through L-alanyl-L-glutamine supplemented total parenteral nutrition after major abdominal surgery: a prospective randomized double-blind controlled study.
OBJECTIVE
Glutamine is recognized as a conditionally essential amino acid. Recent studies indicate that glutamine-containing total parenteral nutrition improves nitrogen economy, enhances gastrointestinal and immune functions and shortens hospital stay.


METHODS
Thirty-seven patients (19 w and 18 m; age 61. 4+/-10.4 years; BMI 23.7+/-2.8 kg/m(2)) following major abdominal surgery receiving an isonitrogenous isoenergetic TPN with or without alanyl-glutamine supplementation (0.5 g/kg BW/day), were evaluated in a double-blind, randomized, controlled trial over a five-day period by measuring nitrogen balance, selected biochemical parameters and length of hospital stay.


RESULTS
Supplemental alanyl-glutamine improved the overall mean (-3.5+/-1.6 vs. -5.5+/-1. 4 g N;P<0.05) and cumulative nitrogen balance (-14.1+/-9.1 vs. -21.7+/-11.4 g N;P<0.05) compared with the isonitrogenous, isoenergetic standard regimen. Alanyl-glutamine normalized plasma glutamine concentration and reduced the length of hospital stay (12.8+/-2.6 vs. 17.5+/-6.4 days;P<0.05).


CONCLUSIONS
The results of the study confirm that supplementation with synthetic alanyl-glutamine dipeptide is associated with cost containment due to shortened hospitalization and improved nitrogen economy.
Mertes
N
N
Department of Anaesthesiology and Intensive Care Medicine, University of Münster, Germany.
Schulzki
C
C
Goeters
C
C
Winde
G
G
Benzing
S
S
Kuhn
K S
KS
Van Aken
H
H
Stehle
P
P
Fürst
P
P
D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000596:Amino Acids / Q000097:blood; D003363:Cost Control; D004151:Dipeptides / Q000008:administration & dosage* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005973:Glutamine / Q000097:blood; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000191:economics; D011182:Postoperative Care / Q000191:economics*; D011446:Prospective Studies; D011506:Proteins / Q000378:metabolism; D013997:Time Factors
D000596:Amino Acids; D004151:Dipeptides; D011506:Proteins; D005973:Glutamine; C054122:alanylglutamine