Enteral glutamine supplementation and morbidity in low birth weight infants.
OBJECTIVE
To determine if glutamine-supplemented enteral nutrition decreased the incidence of nosocomial sepsis in neonates.


METHODS
In a multicenter (n = 20) clinical trial, we randomly allocated infants (n = 649) with birth weight between 500 and 1250 g, who were <7 days of age, and had no major anomalies to receive enteral glutamine supplementation (0.3 g/kg/day) or sterile water (placebo) for the first 28 days. The primary outcome variable was the number of infants who had blood culture-proven nosocomial sepsis between 7 days' and 36 weeks' postmenstrual age.


RESULTS
Infants were assigned to placebo (n = 335) or to glutamine supplementation (n = 314). Neonates assigned to glutamine were similar to those assigned placebo for demographic characteristics and nutritional support during the first week. There was no difference in the occurrence of culture-proven nosocomial sepsis (33.7% vs 30.9%) or suspected sepsis (51.6% vs 47.1%) between the placebo and glutamine groups; however, neonates treated with glutamine less often had gastrointestinal dysfunction (7.5% vs 2.5%, P <.01) and severe neurologic sequelae (15.1% vs 10.4%, P =.08).


CONCLUSIONS
At a dose of 0.3 g/kg/day, enteral glutamine does not appear to reduce nosocomial sepsis in premature neonates.
Vaughn
Phil
P
Pediatrix-Obstetrix Center for Research and Education, Pediatrix Medical Group, Inc, Sunrise, Florida, USA.
Thomas
Pam
P
Clark
Reese
R
Neu
Josef
J
D000293:Adolescent; D000328:Adult; D003428:Cross Infection / Q000628:therapy*; D004750:Enteral Nutrition; D005260:Female; D005973:Glutamine / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D015999:Multivariate Analysis; D018805:Sepsis / Q000628:therapy*
D005973:Glutamine