title: Efficacy of Glutamine-Enriched Nutrition Support for Patients With Severe Acute Pancreatitis: A Meta-Analysis.
abstract: BACKGROUND
  Plasma glutamine (Gln) level has been negatively correlated with the severity of severe acute pancreatitis (SAP). Although Gln is widely used today, the results of individual randomized controlled trials of Gln-enriched nutrition support for patients with SAP are conflicting.
  
  
  METHODS
  PubMed, EMBASE, HighWire, Cochrane Central Register of Controlled Trials, Wanfang, China Journals Full-Text Database, and the Chinese Biomedical Literature Database were searched. Literature published before June 2014 was searched. Randomized controlled trials investigating the comparison of conventional and Gln-enriched nutrition support were included; a random effect model using Rev Man 5.2 software was chosen to complete this meta-analysis. The count data were analyzed using the risk ratio (RR) and 95% confidence interval (CI), and the measurement data were analyzed using the standard mean difference or weighted mean difference and 95% CI. Heterogeneity analyses were conducted by I(2) test; publication bias analyses were conducted by Begg test.
  
  
  RESULTS
  Ten studies were eventually chosen for analysis, including 218 patients who received conventional methods (control group) and 215 patients who received Gln-enriched nutrition support (experimental group). Compared with the control group, Gln is helpful in elevating the albumin level, decreasing C-reaction protein (standard mean difference = 1.01, -1.89; 95% CI: 0.50 to 1.51, -3.23 to -0.56; P < .05), decreasing the incidence of infectious complication and mortality (RR = 0.62, 0.36; 95% CI: 0.46 to 0.83, 0.16 to 0.83; P < .05), and shortening the hospital stay length (weighted mean difference [WMD] = -3.89; 95% CI: -4.98 to -2.81; P < .05) without increasing expenses (WMD = -0.16; 95% CI: -1.34 to 1.02; P > .05). Intravenous infusion manifested more advantages by decreasing the incidence of infectious complications and mortality.
  
  
  CONCLUSIONS
  Gln-enriched nutrition support is superior to conventional methods for SAP, and intravenous infusion may be a better choice for drug administration.
authors: Department of General Surgery, Wuhan Clinical College of Southern Medical University (Wuhan General Hospital of Guangzhou Military Command),Wuhan, Hubei Province, China.
authors: Li
authors: L
authors: Yong
authors: Department of General Surgery, Wuhan Clinical College of Southern Medical University (Wuhan General Hospital of Guangzhou Military Command),Wuhan, Hubei Province, China. ptwklqp111@163.com.
authors: Qi-Ping
authors: QP
authors: Lu
authors: Department of General Surgery, Wuhan Clinical College of Southern Medical University (Wuhan General Hospital of Guangzhou Military Command),Wuhan, Hubei Province, China.
authors: Sheng-Hui
authors: SH
authors: Liu
authors: Department of General Surgery, Wuhan Clinical College of Southern Medical University (Wuhan General Hospital of Guangzhou Military Command),Wuhan, Hubei Province, China.
authors: Hu
authors: H
authors: Fan
mesh_terms: D000208:Acute Disease; D002097:C-Reactive Protein / Q000378:metabolism; D002681:China; D003141:Communicable Diseases / Q000150:complications / Q000628:therapy; D016208:Databases, Factual; D005973:Glutamine / Q000494:pharmacology*; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay; D010195:Pancreatitis / Q000150:complications / Q000401:mortality / Q000628:therapy*; D010288:Parenteral Nutrition; D016032:Randomized Controlled Trials as Topic; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D012709:Serum Albumin; D005973:Glutamine; D002097:C-Reactive Protein
keywords: glutamine; severe acute pancreatitis