title: Effectiveness of perioperative glutamine in parenteral nutrition in patients at risk of moderate to severe malnutrition.
abstract: OBJECTIVE
  To determine whether perioperative glutamine supplementation of parenteral nutrition (PN) has an impact on morbidity and mortality of patients with previous moderate to severe risk of malnutrition.
  
  
  METHODS
  A quasi-experimental study was conducted comparing the following groups: Control group 1: without glutamine dipeptide supplementation of PN during the perioperative period. Control group 2: PN was supplemented with glutamine dipeptide (0.4 g/kg/day) after surgery only. Group 3 (follow-up group): PN was supplemented with glutamine dipeptide (0.4 g/kg/day) in the perioperative period. Postoperative morbidity and mortality was recorded.
  
  
  RESULTS
  Sixty-seven patients matched for baseline and surgical characteristics were recruited into the study. Univariate analysis showed a lower incidence of hyperglycemia and ICU admission in group 3, and a trend to significance (P = 0.078) in terms of a lower incidence of infection. In the multivariate analysis, only group 3 met the models of ICU admission (OR = 0.28), hyperglycemia (OR = 0.11), and renal failure (OR = 0.19).
  
  
  CONCLUSIONS
  The results show that perioperative use of glutamine dipeptide in patients at risk of moderate to severe malnutrition before surgery is an effective option for decreasing the morbidity associated with malnutrition, as it improves blood glucose modulation and reduces infection and ICU stay.
authors.affiliation: Department of Pharmacy, Hospital Mateu Orfila, Maó, Menorca, Spain. gabriel.mercadal@hgmo.es
authors.forename: G
authors.initials: G
authors.lastname: Mercadal Orfila
authors.forename: J M
authors.initials: JM
authors.lastname: Llop Talaverón
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D003422:Critical Care; D002149:Energy Intake; D005260:Female; D005973:Glutamine / Q000627:therapeutic use*; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000188:drug therapy* / Q000401:mortality; D008875:Middle Aged; D015999:Multivariate Analysis; D010288:Parenteral Nutrition; D019990:Perioperative Care; D011182:Postoperative Care; D011184:Postoperative Period; D051437:Renal Insufficiency / Q000150:complications; D012306:Risk
chemical_list: D001786:Blood Glucose; D005973:Glutamine