Clinical outcomes of glutamine supplementation in neonates / 中华临床营养杂志

ABSTRACT

Objective To assess the clinical outcomes of glutamine supplementation in neonates.Methods The study was designed as a double-blind randomized controlled trial.Totally 100 infants were randomly divided into 5 groups with 20 infants in each groupcontrol groupstandard parenteral nutrition (PN);PNI groupPN supplemented with 0.3 g/ (kg·d) glutamine;enteral nutrition (EN) 1 groupEN supplemented with 0.3 g/ (kg·d) glutamine;PN2 groupPN supplemented with 0.3 g/ (kg·d) glutamine;and EN2 groupEN supplemented with 0.3 g/ (kg·d) glutamine,The primary endpoints were the time to establish full enteral nutrition [defined as receiving 120 ml/ (kg·d) enterally],episodes of gastric residuals,total duration of PN,and mortality.The second endpoints were weight gain and head circumference gain,liver function,renal function,days on ventilator,and length of hospitalization.Results Time to achieve full enteral nutrition,incidence of gastric residuals,duration of PN,weight gain (g/d) ,head circumference gain (cm/w),liver function,renal function,and length of hospitalization were not significantly different among all five groups.Days of mechanical ventilation were significantly decreased in PN1 group and PN2 group when compared with the control group (P ＜ 0.05).Intention-totreat analyses showed that,when compared with the control group,PN1 groupRR1.053;95% CI0.952-1.164;ENI groupRR1.333,95% CI1.035-1.717;PN2 groupRR1.053,95% CI0.952-1.164;EN2 groupRR1.25,95% CI1.004-1.556.Conclusions Glutamine supplementation may not be able to decrease the time to achieve full enteral nutrition,the incidence of gastric residuals,and the duration of PN.However,pareneral glutamine supplementation does reduce the days on ventilator in neonates.Also,parenteral glutamine supplementation has no obvious influence on mortality.