title: Glutamine supplementation for young infants with severe gastrointestinal disease.
abstract: BACKGROUND
  Endogenous glutamine biosynthesis may be insufficient to meet the needs of people with severe gastrointestinal disease. Results from studies using experimental animal models of gastrointestinal disease have suggested that glutamine supplementation improves clinical outcomes. This review examines evidence on the effect of glutamine supplementation in young infants with severe gastrointestinal disease.
  
  
  OBJECTIVE
  To assess the effect of supplemental glutamine on mortality and morbidity in young infants with severe gastrointestinal disease.
  
  
  METHODS
  We searcheed the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2014, Issue 8), MEDLINE, EMBASE, and CINAHL (from inception to September 2014), conference proceedings, and reference lists from previous reviews.
  
  
  METHODS
  Randomised or quasi-randomised controlled trials that compared glutamine supplementation versus no glutamine supplementation in infants up to three months old (corrected for preterm birth if necessary) with severe gastrointestinal disease defined as a congenital or acquired gastrointestinal condition that is likely to necessitate providing parenteral nutrition for at least 24 hours.
  
  
  METHODS
  Two review authors assessed trial eligibility and risk of bias and undertook data extraction independently. We analysed the treatment effects in the individual trials and reported the risk ratio (RR) and risk difference (RD) for dichotomous data and mean difference for continuous data, with 95% confidence intervals (CI). We used a fixed-effect model in meta-analyses and explored the potential causes of heterogeneity in sensitivity analyses.
  
  
  RESULTS
  We found three trials in which a total of 274 infants participated. The trials were of good methodological quality but were too small to detect clinically important effects of glutamine supplementation. Meta-analyses did not reveal a statistically significant difference in the risk of death before hospital discharge (typical RR 0.79, 95% CI 0.19 to 3.20; typical RD -0.01, 95% CI -0.05 to 0.03) or in the rate of invasive infection (typical RR 1.37, 95% CI 0.89 to 2.11; typical RD 0.08, 95% CI -0.03 to 0.18]).
  
  
  CONCLUSIONS
  The available data from randomised controlled trials do not suggest that glutamine supplementation has any important benefits for young infants with severe gastrointestinal disease.
authors.affiliation: Centre for Reviews and Dissemination, University of York, York, UK.
authors.forename: Jennifer V E
authors.initials: JV
authors.lastname: Brown
authors.forename: Thirimon
authors.initials: T
authors.lastname: Moe-Byrne
authors.forename: William
authors.initials: W
authors.lastname: McGuire
mesh_terms: D019587:Dietary Supplements; D005767:Gastrointestinal Diseases / Q000188:drug therapy* / Q000401:mortality; D005973:Glutamine / Q000627:therapeutic use*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D016032:Randomized Controlled Trials as Topic
chemical_list: D005973:Glutamine