title: A randomized trial of intravenous glutamine supplementation in trauma ICU patients.
abstract: OBJECTIVE
  To evaluate the effect of the intravenous (i.v.) L-alanyl-L-glutamine dipeptide supplementation during 5 days on clinical outcome in trauma patients admitted to the intensive care unit (ICU).
  
  
  METHODS
  This was a prospective, randomized, double-blind, multicenter trial. Glutamine was not given as a component of nutrition but as an extra infusion. The primary outcome variable was the number of new infections within the first 14 days.
  
  
  RESULTS
  We included 142 patients. There were no differences between groups in baseline characteristics. Up to 62 % of the patients in the placebo group and 63 % in the treatment group presented confirmed infections (p = 0.86). ICU length of stay was 14 days in both groups (p = 0.54). Hospital length of stay was 27 days in the placebo group and 29 in the treatment group (p = 0.88). ICU mortality was 4.2 % in both groups (p = 1). Sixty percent of the patients presented low glutamine levels before randomization. At the end of the treatment (6th day), 48 % of the patients maintained low glutamine levels (39 % of treated patients vs. 57 % in the placebo group). Patients with low glutamine levels at day 6 had more number of infections (58.8 vs. 80.9 %; p = 0.032) and longer ICU (9 vs. 20 days; p < 0.01) and hospital length of stay (24 vs. 41 days; p = 0.01).
  
  
  CONCLUSIONS
  There was no benefit with i.v. L-alanyl-L-glutamine dipeptide supplementation (0.5 g/kg body weight/day of the dipeptide) during 5 days in trauma patients admitted to the ICU. The i.v. glutamine supplementation was not enough to normalize the plasma glutamine levels in all patients. Low plasma glutamine levels at day 6 were associated with a worse outcome.
authors.affiliation: Intensive Care Department, Son Espases University Hospital, Crta Valldemossa 79, 07010, Palma, Spain, juan.perez@ssib.es.
authors.forename: Jon
authors.initials: J
authors.lastname: Pérez-Bárcena
authors.forename: Pedro
authors.initials: P
authors.lastname: Marsé
authors.forename: Arturo
authors.initials: A
authors.lastname: Zabalegui-Pérez
authors.forename: Esther
authors.initials: E
authors.lastname: Corral
authors.forename: Rubén
authors.initials: R
authors.lastname: Herrán-Monge
authors.forename: María
authors.initials: M
authors.lastname: Gero-Escapa
authors.forename: Mercedes
authors.initials: M
authors.lastname: Cervera
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Llompart-Pou
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ayestarán
authors.forename: Joan Maria
authors.initials: JM
authors.lastname: Raurich
authors.forename: Antonio
authors.initials: A
authors.lastname: Oliver
authors.forename: Antonio
authors.initials: A
authors.lastname: Buño
authors.forename: Abelardo
authors.initials: A
authors.lastname: García de Lorenzo
authors.forename: Guiem
authors.initials: G
authors.lastname: Frontera
mesh_terms: D000328:Adult; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D005973:Glutamine / Q000008:administration & dosage* / Q000097:blood; D006801:Humans; D007239:Infections / Q000150:complications; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014947:Wounds and Injuries / Q000097:blood / Q000188:drug therapy* / Q000401:mortality
chemical_list: D005973:Glutamine