A double-blind, randomized, controlled crossover trial of glutamine supplementation in home parenteral nutrition.
OBJECTIVE
Studies suggest clinical benefit of glutamine-supplemented parenteral nutrition. The aim was to determine if the inclusion of 10 g of glutamine as part of the nitrogen source of home parenteral nutrition (HPN) reduces infectious complications.


METHODS
Thirty-five patients on HPN were recruited and 22 completed the study. Patients were randomized to receive either standard HPN or glutamine-supplemented HPN. Patients were assessed at randomization, 3 and 6 months later then they were crossed over to the alternative HPN and reassessed at 3 and 6 months. Assessments included plasma amino acid concentrations, intestinal permeability and absorption, nutritional status, oral and parenteral intake, quality of life, routine biochemistry and haematology.


RESULTS
No difference was seen between the groups at randomization. No difference was detected between the treatment phases for infective complications (55% in the standard treatment phase and 36% in the glutamine-supplemented phase P=0.67). There were no differences in nutritional status, intestinal permeability, plasma glutamine concentrations or quality of life.


CONCLUSIONS
Although limited by the sample size, the study has shown that glutamine as part of the nitrogen source of parenteral nutrition can be given to patients on HPN for 6 months without any adverse effects.
Culkin
A
A
Department of Nutrition and Dietetics, St Mark's Hospital, Harrow, Middlesex, UK. alison.culkin@nwlh.nhs.uk
Gabe
S M
SM
Bjarnason
I
I
Grimble
G
G
Madden
A M
AM
Forbes
A
A
D000596:Amino Acids / Q000097:blood; D018592:Cross-Over Studies; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005973:Glutamine / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007239:Infections / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016331:Parenteral Nutrition, Home / Q000009:adverse effects / Q000379:methods; D010539:Permeability; D011788:Quality of Life
D000596:Amino Acids; D005973:Glutamine