Intravenous glutamine for severe acute pancreatitis: A meta-analysis.
OBJECTIVE
To evaluate the efficacy of intravenous glutamine on the patients with severe acute pancreatitis (SAP).


METHODS
The Cochrane Library, PubMed, EMBASE, and EBM review databases were searched up to June 2012. Randomized controlled trials (RCTs) that compared non-glutamine nutrition with intravenous glutamine supplemented nutrition in patients with SAP were included. A method recommended by the Cochrane Collaboration was used to perform a meta-analysis of those RCTs.


RESULTS
Four RCTs involving a total of 190 participants were included. Analysis of these RCTs revealed the presence of statistical homogeneity among them. Results showed that glutamine dipeptide has a positive effect in reducing the mortality rate (OR = 0.26, 95%CI: 0.09-0.73, P = 0.01), length of hospital stay (weighted mean difference = -4.85, 95%CI: 6.67--3.03, P < 0.001), and the rate of complications (OR = 0.41, 95%CI: 0.22-0.78, P = 0.006). No serious adverse effects were found.


CONCLUSIONS
Current best evidence demonstrates that glutamine is effective for SAP. Further high quality trials are required and parameters of nutritional condition and hospital cost should be considered in future RCTs with sufficient size and rigorous design.
Xin Zhong, Cui-Ping Liang, Shu Gong, Hepato-bilio-pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Xin
X
Zhong
Xin Zhong, Cui-Ping Liang, Shu Gong, Hepato-bilio-pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Cui-Ping
CP
Liang
Xin Zhong, Cui-Ping Liang, Shu Gong, Hepato-bilio-pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Shu
S
Gong
Glutamine; Meta-analysis; Severe acute pancreatitis