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Efficacy of Glutamine‐Enriched Nutrition Support for Patients With Severe Acute Pancreatitis
Author(s) -
Yong Li,
Lu QiPing,
Liu ShengHui,
Fan Hu
Publication year - 2016
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607115570391
Subject(s) - medicine , acute pancreatitis , confidence interval , meta analysis , randomized controlled trial , parenteral nutrition , glutamine , strictly standardized mean difference , relative risk , gastroenterology , mean difference , biochemistry , chemistry , amino acid
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.