[Effects of supply with glutamine on antioxidant system and lipid peroxidation in patients with parenteral nutrition].
BACKGROUND
In the critically ill patient, there is a continuous production of reactive oxygen species (ROS) that need to be neutralized to prevent oxidative stress (OS). Quantitatively speaking, the glutathione system (GSH) is the most important anti-oxidant endogenous defense. To increase it, glutamine supplementation has been shown to be effective by protecting against the oxidative damage and reducing the morbimortality.


OBJECTIVE
To assess the effect of adding an alanylglutamine dipeptide to PN on lipid peroxidation lipidica and glutathione metabolism, as well as its relationship with morbidity in critically ill patients.


METHODS
Determination through spectrophotometry techniques of glutathione peroxidase, glutathione reductase, total glutathione, and maloniladdehyde at admission adn after seven days of hospitalization at the Intensive Care Unit (ICU) in 20 patients older than 18 years on parenteral nutrition therapy.


RESULTS
The group of patients receiving parenteral nutrition with glutamine supplementation had significant increases in total glutathione (42.35+/-13 vs 55.29+/-12 micromol/l; p<0.05) and the enzymatic activity of glutathione peroxidasa (470+/-195 vs 705+/-214 micromol/l; p<0.05) within one week of nutritional therapy, whereas the group on conventional parenteral nutrition did not show significant changes of any of the parameters studied (p>0.05). However, both mortality and ICU stay were not different between the study group, whereas the severity (assessed by the SOFA score) was lower in the group of patients receiving glutamine (SOFA 5+/-2 vs 8+/-1.8; p<0.05).


CONCLUSIONS
Glutamine intake in critically ill patients improves the antioxidant defenses, which leads to lower lipid peroxidation and lower morbidity during admission at the ICU.
Abilés
J
J
Unidad de Nutrición Clínica y Dietética, Hospital Universitario Virgen de las Nieves, Granada, Spain. jimesolea@yahoo.es
Moreno-Torres
R
R
Moratalla
G
G
Castaño
J
J
Pérez Abúd
R
R
Mudarra
A
A
Machado
Ma J
MJ
Planells
E
E
Pérez de la Cruz
A
A
D000328:Adult; D000368:Aged; D000975:Antioxidants; D019587:Dietary Supplements; D005260:Female; D005973:Glutamine / Q000494:pharmacology*; D006801:Humans; D015227:Lipid Peroxidation / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D010865:Pilot Projects; D011446:Prospective Studies
D000975:Antioxidants; D005973:Glutamine