title: A randomised controlled trial of glutamine-enriched neonatal parenteral nutrition in Malaysia.
abstract: BACKGROUND
  The addition of glutamine to parenteral nutrition (PN) in neonates has not shown significant benefits as compared to adults thus far. This study aimed to determine the potential benefits of the addition of glutamine to neonatal PN in a tertiary hospital in a middle-income country.
  
  
  METHODS
  This was a double-blinded randomised controlled trial. Babies who were admitted to the neonatal intensive care unit (NICU) and who required PN were eligible for inclusion in the study. The subjects were randomised to receive either glutamine-added PN (intervention) or standard PN (control). The most important outcomes included time to full enteral nutrition, incidence of sepsis and necrotising enterocolitis (NEC), clinical or culture-proven sepsis.
  
  
  RESULTS
  Out of 270 subjects, 132 were randomised to the intervention group and 138, to the control group. Baseline data were comparable in both groups. The median time taken to reach full enteral nutrition was similar for both intervention and control groups (six days in each group, p-value is 0.52). The incidences of NEC, clinical sepsis and culture-proven sepsis did not differ significantly in the intervention and control groups (5.8 vs. 7.1 percent, p-value is 0.68; 15.7 percent vs. 10.2 percent, p-value is 0.21 and 16.5 percent vs. 15.7 percent, p-value is 0.38, respectively). Other outcomes such as duration of ventilation, duration of NICU stay and a subgroup analysis for preterm and term babies also showed no statistically significant differences.
  
  
  CONCLUSIONS
  Addition of glutamine to neonatal PN was not shown to improve outcome.
authors.affiliation: Paediatric Department, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia. drikram@kk.usm.my
authors.forename: I
authors.initials: I
authors.lastname: Mohamad Ikram
authors.forename: B S
authors.initials: BS
authors.lastname: Quah
authors.forename: R
authors.initials: R
authors.lastname: Noraida
authors.forename: S
authors.initials: S
authors.lastname: Djokomuljanto
authors.forename: C Y
authors.initials: CY
authors.lastname: Faris Irfan
authors.forename: H
authors.initials: H
authors.lastname: Van Rostenberghe
mesh_terms: D004311:Double-Blind Method; D004750:Enteral Nutrition; D005260:Female; D005973:Glutamine / Q000627:therapeutic use*; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008296:Malaysia; D008297:Male; D010288:Parenteral Nutrition; D012141:Respiratory Tract Infections / Q000175:diagnosis; D018805:Sepsis / Q000382:microbiology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D005973:Glutamine