Open AccessPilot study with a glutamine-supplemented enteral formula in critically ill infants
Author(s) -
Eliana Barbosa,
Emília Addison Machado Moreira,
José Eduardo Coutinho Góes,
Joel Faintuch
Publication year - 1999
Publication title -
revista do hospital das clínicas
Language(s) - English
Resource type - Journals
eISSN - 1678-9903
pISSN - 0041-8781
DOI - 10.1590/s0041-87811999000100005
Subject(s) - critically ill , glutamine , enteral administration , intensive care medicine , medicine , critical illness , parenteral nutrition , chemistry , biochemistry , amino acid
Seriously ill infants often display protein-calorie malnutrition due to the metabolic demands of sepsis and respiratory failure. Glutamine has been classified as a conditionally essential amino acid, with special usefulness in critical patients. Immunomodulation, gut protection, and prevention of protein depletion are mentioned among its positive effects in such circumstances. With the intent of evaluating the tolerance and clinical impact of a glutamine supplement in seriously ill infants, a prospective randomized study was done with nine patients. Anthropometric and biochemical determinations were made, and length of stay in the intensive care unit (ICU), in the hospital, and under artificial ventilation, and septic morbidity and mortality were tabulated. Infants in the treatment group (n = 5) were enterally administered 0.3 g/kg of glutamine, whereas controls received 0.3 g/kg of casein during a standard period of five days. Septic complications occurred in 75% of the controls (3/4) versus 20% of the glutamine-treated group (1/5, p < or = 0.10), and two patients in the control group died of bacterial infections (50% vs. 0%, p < or = 0.10). Days in the ICU, in the hospital, and with ventilation numerically favored glutamine therapy, although without statistical significance. The supplements were usually well tolerated, and no patient required discontinuation of the program. The conclusion was that glutamine supplementation was safe and tended to be associated with less infectious morbidity and mortality in this high-risk population.