Skip to main content

Comparison of the effects of intravenous, enteral and enteral + intravenous supply of glutamine on malnutrition in sepsis

Introduction

Our aim was to compare the effects of intravenous, enteral and intravenous + enteral supplemented glutamine on prediction of positive feeding parameters (transferrin, nitrogen balance and creatine/height index) for malnutrition in septic patients.

Methods

This was a prospective, randomized, controlled, single-blind, clinical study. Forty septic patients with malnutrition were randomly divided into four groups (n = 10 each group). All patients were receiving enteral access, and had a clinical diagnosis of either severe sepsis or septic shock. All patients received enteral nutrition during 15 days. Enteral feeding was delivered at a constant rate to achieve energy expenditure (Harris-Benedict equation). Blood and urine samples were obtained for transferrin, nitrogen balance and creatine/height index at least at baseline and on study days 7 and 15. Group 1: received 30 g/day intravenous glutamine, Group 2: received 30 g/day enteral glutamine, Group 3: received 15 g/day enteral + 15 g/day intravenous glutamine, Group 4: control group, without glutamine only enteral feeding. Data were compared by the Tukey HSD test.

Results

Nitrogen balance levels were not significantly different between groups on the first 7 and 15 days. The transferrin level was higher in Group 2 than Group 4 on the first 7 days (P < 0.001). Transferrin levels were not significantly different between the other groups. Transferrin levels were higher in Group 3 than Group 2 (P < 0.05) and Group 4 (P < 0.001) in 15 days. Creatine/height index was higher in Group 3 than Group 4 (P < 0.05) in 15 days.

Conclusions

Enteral plus intravenous supplemented glutamine has more beneficial effects on transferrin and creatine/height index than only enteral or intravenous supply of glutamine. Also, we observed that enteral feeding of supplemented glutamine has beneficial effects on transferrin, nitrogen balance and creatine/height index in Groups 1, 2 and 3 when compared with Group 4.

References

  1. 1.

    Novak F, Heyland DK, et al.: Glutamine supplementation in serious illness: a systematic review of the evidence. Crit Care Med 2002, 30: 2022-2029. 10.1097/00003246-200209000-00011

    CAS  Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to G Koksal.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Koksal, G., Karaören, G., Akarcay, H. et al. Comparison of the effects of intravenous, enteral and enteral + intravenous supply of glutamine on malnutrition in sepsis. Crit Care 15, P385 (2011). https://doi.org/10.1186/cc9805

Download citation

Keywords

  • Glutamine
  • Septic Shock
  • Transferrin
  • Severe Sepsis
  • Enteral Nutrition