Glutamine supplementation: Is it beneficial to critically ill children?

Although there have been several randomized trials, conducted with critically ill adults, reporting the benefitsof glutamine supplementation, there is scarce information on the role of glutamine in the treatment outcomeof critically ill children. Our objective was to evaluate existing studies on the...

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Detalles Bibliográficos
Autores: PACÍFICO, Stefânia Lucizani, Pons LEITE, Heitor, Brunow de CARVALHO, Werther
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:Brasil
Institución:Pontifícia Universidade Católica de Campinas (PUC-CAMPINAS)
Repositorio:Revista de Nutrição
Idioma:portugués
OAI Identifier:oai:ojs.periodicos.puc-campinas.edu.br:article/9812
Acceso en línea:https://periodicos.puc-campinas.edu.br/nutricao/article/view/9812
Access Level:acceso abierto
Palabra clave:child
glutamine
enteral nutrition
parenteral nutrition
suplementary feeding
intensive care
criança
glutamina
nutrição enteral
nutrição parenteral
suplementação
terapia intensiva
Descripción
Sumario:Although there have been several randomized trials, conducted with critically ill adults, reporting the benefitsof glutamine supplementation, there is scarce information on the role of glutamine in the treatment outcomeof critically ill children. Our objective was to evaluate existing studies on the effect of glutamine supplementation,aiming at verifying the clinical benefits of such supplementation for critically ill children. A computerizedsearch was conducted to select prospective, randomized, clinical trials of critically ill children, publishedbetween 1992 and 2003. Studies were included if, besides presenting the characteristics already mentioned,they evaluated the effects of parenteral and the enteral glutamine supplementing vs. those of standard care.The variables on clinical outcomes were: time to achieve full enteral nutrition, hospital length of stay,complication rates, and mortality. Three bibliographic databases were searched: Medline, LILACS and CochraneLibrary. Search terms included: glutamine, critically ill, trauma, sepsis, burned, injured, bone marrowtransplantation, intensive care, and mechanic ventilation. Initial screening resulted in 33 original articles; ofthese potentially eligible articles, only 7 fulfilled the inclusion criteria. Length of hospital stay, mortality rate,and hospital costs were not different for patients receiving glutamine-supplemented nutrition, when comparedto those receiving non-supplemented diet. Glutamine was associated with reduction in the time necessary toachieve full enteral feeding and parenteral nutrition. There is no evidence to support the routine use of eitherparenteral or enteral glutamine supplement when treating critically ill children. The small number of patients,heterogeneity with respect to the studied groups, routes of administration, and confounding effects ofconcomitant diseases, all limit the inferences we can make from the results.