Effect of oral glutamine administration on oxidative stress, morbidity and mortality in critically ill surgical patients.
OBJECTIVE
To examine the effect of enteral administration of glutamine in patients with peritonitis or abdominal trauma.


METHODS
In a prospective, interventional, observer-blind, randomized clinical trial, 120 patients, aged 18-60 years, were randomized to receive either enteral glutamine 45 g/day for 5 days in addition to standard care (n=63; group A) or standard care alone (n=57; group B). Surgical intervention was done as needed.


RESULTS
The two groups were comparable for sex and severity of illness scores. Following treatment, serum malondialdehyde (MDA) levels in group A increased from 4.4 (8.0) to 7.2 (4.8) mmol/mL, whereas those in group B decreased from 3.9 (4.9) to 3.1 (5.0) mmol/mL; these changes were not statistically significant. Reduced glutathione levels increased from 0.03 (0.04) to 0.06 (0.12) mg/g Hb (p=0.032) after treatment in group A and from 0.03 (0.03) to 0.05 (0.04) mg/g Hb (p=0.001) in group B. Infectious complications were equally frequent in the two groups (group A: 44; group B: 37; p=0.571). Survival rate and duration of hospital stay were also comparable in the two groups.


CONCLUSIONS
Enteral glutamine supplementation offers no advantage in patients with peritonitis or abdominal trauma.
Kumar
Sunil
S
Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110 095, India. drskg_15@rediffmail.com
Kumar
Ritesh
R
Sharma
Suman Bala
SB
Jain
Bhupendra Kumar
BK
D000007:Abdominal Injuries / Q000401:mortality / Q000628:therapy; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D003422:Critical Care; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D004750:Enteral Nutrition; D005260:Female; D005973:Glutamine / Q000008:administration & dosage*; D017052:Hospital Mortality; D006801:Humans; D007194:India; D007416:Intestinal Perforation / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D010538:Peritonitis / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D015996:Survival Rate
D005973:Glutamine