4.2 Review

Glutamine on critical-ill patients: a systematic review and meta-analysis

Journal

ANNALS OF PALLIATIVE MEDICINE
Volume 10, Issue 2, Pages 1503-1520

Publisher

AME PUBL CO
DOI: 10.21037/apm-20-702

Keywords

Glutamine; critically ill patients; intensive care unit (ICU); nutrition

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A meta-analysis of 47 randomized controlled trials on the effect of glutamine supplements in adult critical-ill patients found that while there was no significant impact on hospital mortality, it did show a positive effect in reducing the duration of mechanical ventilation. Further subgroup analysis showed consistent trends in severely burned patients, but not in other subgroups.
Background: To conduct a meta-analysis of the effect of glutamine supplements on prognosis in adult critical-ill patients. Methods: We searched the Web of Science, Cochrane library, PubMed, the Wanfang Database, and the China National Knowledge Infrastructure (CNKI)/CBMdisc database. The primary outcome was hospital mortality, or if not reported, 28-day/6-month/intensive care unit (ICU) mortality. The secondary outcomes were duration of mechanical ventilation (MV), length of stay (LOS) in the ICU, LOS in the hospital, and nosocomial infections. Results: In 599 related articles, 47 randomized controlled trials, including 6,198 patients, met all the inclusion criteria. Hospital mortality was not significantly different between the glutamine group and the control group. Length of MV was significantly higher in the control group than that of the glutamine group. In a subgroup analysis of severely burned patients, hospital mortality had the same trend. In other subgroups, there was no significant difference between the two groups. Conclusions: We suggest that supplemental glutamine need not be routinely added to the diet of criticalill patients to reduce hospital mortality, with the exception of the diet of severely burned patients.

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