Influence of polymeric enteral nutrition supplemented with different doses of glutamine on gut permeability in critically ill patients.
OBJECTIVE
To evaluate the effect of glutamine-supplemented polymeric enteral formulas on the recovery of gut-permeability abnormalities in critically ill patients.


METHODS
Twenty-three patients were randomized to receive a conventional casein-based enteral formula (ADN), ADN plus glutamine in a dose of 0.15 g x kg(-1) x d(-1) or ADN plus 0.30 g x kg(-1) x d(-1) of glutamine for 8 d. The lactulose mannitol permeability test (L/M) was performed at baseline and at the end of the study. Nineteen healthy volunteers served as controls for the L/M test.


RESULTS
An increase in permeability compared with control subjects was observed in patients at baseline (mean +/- standard error of the mean; L/M ratio: 0.11 +/- 0.03 and 0.025 +/- 0.004, respectively; P < 0.02). The L/M ratio improved after the period of enteral nutrition as a whole (initial L/M: 0.11 +/- 0.03, final L/M: 0.061 +/- 0.01; P < 0.03), but no difference was found between groups.


CONCLUSIONS
Even though polymeric enteral nutrition was associated with a significant improvement in the L/M ratio, glutamine supplementation did not show a specific influence in improving recovery of gut permeability in critically ill patients.
Velasco
N
N
Hospital Clínico, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Hernandez
G
G
Wainstein
C
C
Castillo
L
L
Maiz
A
A
Lopez
F
F
Guzman
S
S
Bugedo
G
G
Acosta
A M
AM
Bruhn
A
A
D000328:Adult; D000368:Aged; D016638:Critical Illness / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D004750:Enteral Nutrition / Q000379:methods; D005260:Female; D005526:Food, Formulated; D005973:Glutamine / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007408:Intestinal Absorption; D007413:Intestinal Mucosa / Q000378:metabolism* / Q000503:physiopathology; D007792:Lactulose; D008297:Male; D008353:Mannitol; D008875:Middle Aged; D010539:Permeability
D005973:Glutamine; D008353:Mannitol; D007792:Lactulose