title: Influence of polymeric enteral nutrition supplemented with different doses of glutamine on gut permeability in critically ill patients.
abstract: 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.
authors.affiliation: Hospital Clínico, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: N
authors.initials: N
authors.lastname: Velasco
authors.forename: G
authors.initials: G
authors.lastname: Hernandez
authors.forename: C
authors.initials: C
authors.lastname: Wainstein
authors.forename: L
authors.initials: L
authors.lastname: Castillo
authors.forename: A
authors.initials: A
authors.lastname: Maiz
authors.forename: F
authors.initials: F
authors.lastname: Lopez
authors.forename: S
authors.initials: S
authors.lastname: Guzman
authors.forename: G
authors.initials: G
authors.lastname: Bugedo
authors.forename: A M
authors.initials: AM
authors.lastname: Acosta
authors.forename: A
authors.initials: A
authors.lastname: Bruhn
mesh_terms: 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
chemical_list: D005973:Glutamine; D008353:Mannitol; D007792:Lactulose