Effects of parenteral glutamine in critically ill surgical patients: a systematic review and meta-analysis

• Published in: Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral Vol. 34; no. 3; pp. 616 - 621
• Main Authors: Pimentel, Rodrigo Fernandes Weyll, Fernandes, Sandra Lúcia
• Format: Journal Article
• Language: English
• Published: Spain Grupo Arán 13-07-2020
• Subjects: Critical Illness - therapy; General Surgery; Glutamine - administration & dosage; Glutamine - therapeutic use; Hospital Mortality; Humans; Length of Stay; Nutrition & Dietetics; Parenteral Nutrition; Postoperative Complications - prevention & control; Randomized Controlled Trials as Topic; Glutamina. Nutrición parenteral. Pacientes quirúrgicos críticos. Metaanálisis; Nutrición parenteral; Metaanálisis; Glutamina; Pacientes quirúrgicos críticos; Critical surgical patients; Parenteral nutrition; Glutamine; Meta-analysis
• ISSN: 0212-1611; 1699-5198; 1699-5198
• DOI: 10.20960/nh.02949

Introduction: glutamine (GLN), the most abundant non-essential amino acid in the plasma, tends to be rapidly depleted in cells in situations of metabolic stress. Some studies have demonstrated the benefits of GLN supplementation on mortality, infection, and length of hospital stay. The objective of this review was to analyze whether parenteral supplementation with GLN has any relevant effect in critically ill surgical patients. Methods: based on a systematic database search, randomized clinical trials (RCTs) published since 1985 were included if they had evaluated the effect of parenteral GLN supplementation in critical surgical patients. The statistical analysis was performed using the RevMan 5.3 software. Results: seven RCTs were eligible for the meta-analysis. Parenteral glutamine supplementation was associated with a non-significant 24 % reduction in mortality (RR = 0.76; 95 % CI: 0.50-1.15). Infections were significantly reduced (RR = 0.60; 95 % CI: 0.45-0.80), and length of hospital stay was 4.09 days shorter (95 % CI: -6.71 to -1.46). Conclusion: parenteral GLN usage in critical surgical patients seems to decrease infection and length of hospital stay, but we could not demonstrate a significant reduction in mortality.