Does enteral glutamine supplementation decrease infectious morbidity?
BACKGROUND
Although some studies have demonstrated lower infectious morbidity in patients receiving supplemental glutamine, there remains no consensus on the utility of such treatment. This study was designed to investigate the effects of supplemental enteral glutamine on the rate and outcomes of infection in critically ill surgical patients.


METHODS
All 185 surgical and trauma patients admitted to a single university surgical trauma intensive care unit (STICU) over an approximately three-year period who were to receive enteral nutrition support were assigned sequentially to one of three diets: standard 1-kCal/mL feedings with added protein (Group 1), standard feedings with glutamine 0.6 g/kg per day (Group 2), or immune-modulated feedings with a similar amount of glutamine (Group 3). Group compositions and patient characteristics were similar at baseline. Data were collected prospectively on infections acquired during hospitalization.


RESULTS
A total of 119 patients had at least one infection: 59% of the patients in Group 1, 64% of Group 2, and 69% of Group 3 (p = NS). There were no differences among the groups in the mean number of infections. The most common sites in all groups were the lungs, blood, and urine; and the frequencies of these infections did not differ between groups. Minor differences were found between groups in the organisms isolated. Antibiotic usage did not differ.


CONCLUSIONS
Supplemental enteral glutamine in the dose studied does not appear to influence the acquisition or characteristics of infection in patients admitted to a mixed STICU.
Schulman
Alison Saalwachter
AS
Department of Surgery, University of Virginia Health System, Charlottesville, Virginia 22908-0709, USA.
Willcutts
Kate F
KF
Claridge
Jeffrey A
JA
O'Donnell
Kelly B
KB
Radigan
Amy E
AE
Evans
Heather L
HL
McElearney
Shannon T
ST
Hedrick
Traci L
TL
Lowson
Stuart M
SM
Schirmer
Bruce D
BD
Young
Jeffrey S
JS
Sawyer
Robert G
RG
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D016638:Critical Illness / Q000628:therapy*; D003428:Cross Infection / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004750:Enteral Nutrition; D005973:Glutamine / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
D005973:Glutamine