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  • Open Access

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

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Critical Care201115 (Suppl 1) :P385

  • Published:


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


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.


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.


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.


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.

Authors’ Affiliations

I.U Cerrahpasa Medical Faculty, Istanbul, Turkey


  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. 10.1097/00003246-200209000-00011View ArticlePubMedGoogle Scholar


© Koksal et al. 2011

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.