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Glutamine in Clinical Nutrition pp 207–217Cite as

Potential for Glutamine Supplementation in Critically Ill Children

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Part of the book series: Nutrition and Health ((NH))

Abstract

Glutamine serves as a primary fuel for rapidly dividing cells, such as in the gut and immune system, and is used as a source of nitrogen to refill the citric acid cycle. During critical illness, the demand for glutamine may exceed that which can be mobilised from muscle stores. Clinical data over the past 20 years have provided evidence that glutamine supplementation may reduce mortality, the occurrence of infections and hospital length of stay in such patients. Experimental work has proposed various mechanisms of glutamine action but none of the randomised studies in early life could demonstrate any effect on mortality and only a few showed some effect in inflammatory response, organ function and a trend for infection control. However, the beneficial effect of glutamine, in adult and experimental models of sepsis, appears to be HSP70 dependent. The aim of this systematic literature review is to examine whether glutamine supplementation improves outcome in infants and children. Methodological problems in clinical trials and interrelations with stress-induced heat-shock protein and inflammatory response should be considered in future research involving glutamine supplementation in premature infants and critically ill children.

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Acknowledgements

This research has been cofinanced by the European Union (European Social Fund (ESF)) and Greek national funds through the Operational Program “Education and Lifelong Learning” of the National Strategic Reference Framework (NSRF)-Research Funding Program: THALES.

Conflict of Interests 

The authors declare that there have no conflicts of interests.

Author information

Authors and Affiliations

  1. 1st Department of Internal Medicine–Propaedeutic, “Laiko” Hospital, University of Athens, Agiou Thoma Road, Athens, Attiki, 115 27, Greece

    Efrossini Briassouli M.D.

  2. Department of Paediatrics, Imperial College London, Norfolk Place, St. Mary’s Campus, London, W2 1PG, UK

    Luise Victoria Marino M. Med. Sci. Nutrition, Ph.D.

  3. Department of Paediatric Intensive Care, School of Medicine, University of Crete, Voutes area, Heraklion, Crete, 71110, Greece

    George Briassoulis M.D., Ph.D.

Authors
  1. Efrossini Briassouli M.D.
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  2. Luise Victoria Marino M. Med. Sci. Nutrition, Ph.D.
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  3. George Briassoulis M.D., Ph.D.
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Corresponding author

Correspondence to George Briassoulis M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Intensive Care, Barnet and Chase Farm Hospitals, London, United Kingdom

    Rajkumar Rajendram

  2. Department of Nutrition and Dietetics, Diabetes and Nutritional Sciences, School of Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Briassouli, E., Marino, L.V., Briassoulis, G. (2015). Potential for Glutamine Supplementation in Critically Ill Children. In: Rajendram, R., Preedy, V., Patel, V. (eds) Glutamine in Clinical Nutrition. Nutrition and Health. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-1932-1_16

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  • DOI: https://doi.org/10.1007/978-1-4939-1932-1_16

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  • Publisher Name: Humana Press, New York, NY

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