Effect of oral glutamine administration on oxidative stress, morbidity and mortality in critically ill surgical patients.

ABSTRACT

OBJECTIVE: To examine the effect of enteral administration of glutamine in patients with peritonitis or abdominal trauma. METHODS: In a prospective, interventional, observer-blind, randomized clinical trial, 120 patients, aged 18-60 years, were randomized to receive either enteral glutamine 45 g/day for 5 days in addition to standard care (n=63; group A) or standard care alone (n=57; group B). Surgical intervention was done as needed. RESULTS: The two groups were comparable for sex and severity of illness scores. Following treatment, serum malondialdehyde (MDA) levels in group A increased from 4.4 (8.0) to 7.2 (4.8) mmol/mL, whereas those in group B decreased from 3.9 (4.9) to 3.1 (5.0) mmol/mL; these changes were not statistically significant. Reduced glutathione levels increased from 0.03 (0.04) to 0.06 (0.12) mg/g Hb (p=0.032) after treatment in group A and from 0.03 (0.03) to 0.05 (0.04) mg/g Hb (p=0.001) in group B. Infectious complications were equally frequent in the two groups (group A 44; group B 37; p=0.571). Survival rate and duration of hospital stay were also comparable in the two groups. CONCLUSION: Enteral glutamine supplementation offers no advantage in patients with peritonitis or abdominal trauma.