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A prospective randomized trial of enteral glutamine in critical illness

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Abstract

Objective

To assess the influence of enteral glutamine on the incidence of severe sepsis and death in critically ill patients.

Design

This two-armed clinical trial was triple blind (patients, attending staff, research nurse).

Setting

The 10 bed general ICU at Royal Perth Hospital, Western Australia.

Patients

This trial evaluated 363 patients requiring mechanical ventilation (median APACHE II score=14); of these, 85 had trauma.

Intervention

The intervention solution contained 20 g/l glutamine and the control solution was isojoulic and isonitrogenous.

Measurements and results

The groups had similar characteristics at baseline, and they also received equivalent amounts of protein and energy. Patients in the glutamine group received a median of 19 g/glutamine per day and 91% (332 of 363) of the patients were fed via a nasogastric tube (median duration=10 days). The outcomes were similar in the two groups: (a) death within 6 months: glutamine group 15% (27 of 179) vs control group 16% (30 of 184); p=0.75; relative risk, 0.95 (95% confidence interval, 0.71–1.28); and (b) severe sepsis: glutamine group 21% (38 of 179) vs control group 23% (43 of 184); p=0.62; relative risk, 0.94 (95% confidence interval, 0.72–1.22). There was also no discernable difference in the secondary outcomes relating to infections, febrile period, antimicrobial therapy, and consumption of inotropes.

Conclusion

This clinical trial did not support the use of enteral glutamine supplements in similar cohorts of critically ill patients.

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Acknowledgements. This study was funded by the National Health and Medical Research Council of Australia. The authors thank the ICU staff at Royal Perth Hospital for facilitating the performance of this study. We are particularly indebted to the staff of the Feed Preparation Room at Royal Perth Hospital for their generous support of this clinical trial.

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Authors and Affiliations

  1. Department of Surgery, The University of Western Australia, Wellington Street, 6000, Perth WA, Australia

    John C. Hall, Jane Hall & Rosalie McCauley

  2. Intensive Care Unit, Royal Perth Hospital, Perth, Western Australia

    Geoffrey Dobb, Ruth de Sousa & Lisa Brennan

Authors
  1. John C. Hall
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  2. Geoffrey Dobb
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  3. Jane Hall
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  4. Ruth de Sousa
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  5. Lisa Brennan
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  6. Rosalie McCauley
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Corresponding author

Correspondence to John C. Hall.

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Hall, J.C., Dobb, G., Hall, J. et al. A prospective randomized trial of enteral glutamine in critical illness. Intensive Care Med 29, 1710–1716 (2003). https://doi.org/10.1007/s00134-003-1937-2

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  • DOI: https://doi.org/10.1007/s00134-003-1937-2

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