title: A meta-analysis of trials using the intention to treat principle for glutamine supplementation in critically ill patients with burn.
abstract: BACKGROUND
  During critical illness, the demand for glutamine may exceed that which can be mobilized from muscle stores. Infections increase mortality, morbidity, length-of-stay, antibiotic usage and the cost of care. This is a major health care issue.
  
  
  METHODS
  RCTs were identified from the electronic databases: the Cochrane Library, MEDLINE, PubMed web of knowledge and hand searching journals. The trials compared the supplementation with glutamine and non-supplementation in burn. Statistical analysis was performed using RevMan5.1 software, from Cochrane Collaboration.
  
  
  RESULTS
  216 papers showed a match, in the keyword search. Upon screening the title, reading the abstract and the entire article, only four RCTs, involving 155 patients, were included. For both the glutamine group and control group, total burn surface area (TBSA) (MD=2.02, 95% CI -2.17, 6.21, p=0.34) was similar. Glutamine supplementation was associated with a statistically significant decrease in the number of patients with gram-negative bacteremia (OR 0.27, 95% CI 0.08-0.92, p=0.04) and hospital mortality (OR=0.13, 95% CI 0.03, 0.51, p=0.004), however, no statistical difference was noted between groups, for the other results.
  
  
  CONCLUSIONS
  Glutamine supplemented nutrition can be associated with a reduction in mortality in hospital, complications due to gram-negative bacteremia in burn patients. Further larger and better quality trials are required, in order to determine whether any differences are statistically and clinically important.
authors: Department of Pharmacy, Fong-Yuan Hospital Department of Health Executive Yuan, Taiwan, ROC. baicalin@yahoo.com.tw
authors: Jiun-Jie
authors: JJ
authors: Lin
authors: Xiu-Juan
authors: XJ
authors: Chung
authors: Chung-Yih
authors: CY
authors: Yang
authors: Hui-Ling
authors: HL
authors: Lau
mesh_terms: D002056:Burns / Q000188:drug therapy* / Q000401:mortality; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000628:therapy; D019587:Dietary Supplements; D005973:Glutamine / Q000008:administration & dosage*; D017052:Hospital Mortality; D006801:Humans; D057194:Intention to Treat Analysis; D016032:Randomized Controlled Trials as Topic
chemical_list: D005973:Glutamine