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The Glutamine Debate in Surgery and Critical Care

The Glutamine Debate in Surgery and Critical Care

Three recent meta-analyses have confirmed traditional glutamine (GLN)-supplemented (or “GLN-Complemented” – providing GLN for completeness of amino acid content) TPN is safe, reduces mortality and improves outcome in surgical and ICU patients. Patients in need of TPN, burns, trauma or malignancies should continue to benefit from supplemental GLN, administered either intravenously at less than 0.35 g/kg/day or enterally at less than 0.5 g/kg/day. Further, a large trial of EN GLN supplementation in burns is ongoing. Thus, when used per guideline recommendations, the GLN story is likely still relevant to ICU outcomes and research.

This analysis showed GLN supplementation of TPN led to reduced infections, LOS and hospital mortality. These trials indicate a risk of increased mortality when GLN is given to patients in shock, renal failure, and early in acute phase of critical care.

June 27, 2019

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