title: Glutamine supplemented parenteral nutrition to prevent ventilator-associated pneumonia in the intensive care unit.
abstract: OBJECTIVE
  Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN). We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU).
  
  
  METHODS
  With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20), and the second was prescribed TPN (n=20) while the third group was given glutamine-supplemented TPN (n=20). C-reactive protein (CRP), sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs.
  
  
  RESULTS
  No statistically significant difference was found among groups in terms of development of VAP (p=0.622).
  
  
  CONCLUSIONS
  Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP.
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey.
authors.forename: Meltem Türkay
authors.initials: MT
authors.lastname: Aydoğmuş
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Rize University, Rize, Turkey.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Tomak
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Tekin
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Katı
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey.
authors.forename: Urfettin
authors.initials: U
authors.lastname: Hüseyinoğlu
keywords: Nutritional support; glutamine; ventilator-associated pneumonia