A commentary on the 2015 Canadian Clinical Practice Guidelines in glutamine supplementation to parenteral nutrition

Leguina-Ruzzi, Alberto

doi:10.1186/s13054-015-1175-3

Cited by 7 publications

(5 citation statements)

References 11 publications

(10 reference statements)

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“…Other nutritional supplements such as glutamine have been suggested as beneficial for critical care pathophysiological condition [35] and also in the economical aspect [36]; however, for the use of SMOF emulsions, no controversial evidence has emerged that could limit its use. Moreover, the recent approval by the FDA for its use in the United States will widely benefit the ICU units over the continent.…”

Section: Discussionmentioning

confidence: 99%

Current Evidence for the Use of Smoflipid® Emulsion in Critical Care Patients for Parenteral Nutrition

Leguina-Ruzzi

Ortiz

2018

Critical Care Research and Practice

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There are strong data showing that malnutrition is highly prevalent in intensive care unit patients (20–50% in the worldwide), presenting a negative accumulated body energy balance. This results in an increased mortality, infections, and hospital length stay with high costs associated with the total treatment. Parenteral nutrition is the first option when the patient's physical condition is not suitable for oral nutrient intake. It is composed essentially by lipids as an energy source, metabolic, and structural function. However, these patients also require a mixture of essential and nonessential fatty acids (SMOF emulsions) to supply not only energy needs but also restore immunological, anti-inflammatory, and proregenerative functions. A revision of the safety and efficacy of Smoflipid® in patients requiring long-term parenteral nutrition was discussed here. Although controversial data are available indicating the contraindications or effectiveness of its use, most of studies presented indicate favorable benefits associated with improved clinical outcomes. The reported roles of this supplementation include positive immunomodulatory and anti-inflammatory effects, positive impact in liver function, reduction of hospital stay, and nosocomial infections as additional contributions to its energetic role, which in many cases results in reduced total costs per patient. Finally, many authors propose that the use of Smoflipid® should become a gold standard of parenteral nutrition in intensive unit care patients and that the costs associated with this supplement should not be limiting for its use, not only to improve the clinical outcome but also to reduce the treatment costs.

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Section: Discussionmentioning

confidence: 99%

Current Evidence for the Use of Smoflipid® Emulsion in Critical Care Patients for Parenteral Nutrition

Leguina-Ruzzi

Ortiz

2018

Critical Care Research and Practice

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“…This amino acid is very multifaceted as it can be used for gluconeogenesis and de novo synthesis of amino acids and proteins amongst other metabolically relevant functions. Further, glutamine is called the “nitrogen shuttle”, as it transports one third of all nitrogen in the blood derived from amino acids [88] (p. 189). In immune-related catabolic conditions, muscles show a high glutamine output to feed lymphocytes and macrophages.…”

Section: Anti-inflammatory Dietary Strategiesmentioning

confidence: 99%

“…In immune-related catabolic conditions, muscles show a high glutamine output to feed lymphocytes and macrophages. This makes this semi-essential amino acid become essential [88]. Furthermore, glutamine acts on the production of pro-inflammatory cytokines of human mucosal cells [89].…”

Section: Anti-inflammatory Dietary Strategiesmentioning

confidence: 99%

Anti-Inflammatory Diets and Fatigue

2019

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Accumulating data indicates a link between a pro-inflammatory status and occurrence of chronic disease-related fatigue. The questions are whether the observed inflammatory profile can be (a) improved by anti-inflammatory diets, and (b) if this improvement can in turn be translated into a significant fatigue reduction. The aim of this narrative review was to investigate the effect of anti-inflammatory nutrients, foods, and diets on inflammatory markers and fatigue in various patient populations. Next to observational and epidemiological studies, a total of 21 human trials have been evaluated in this work. Current available research is indicative, rather than evident, regarding the effectiveness of individuals’ use of single nutrients with anti-inflammatory and fatigue-reducing effects. In contrast, clinical studies demonstrate that a balanced diet with whole grains high in fibers, polyphenol-rich vegetables, and omega-3 fatty acid-rich foods might be able to improve disease-related fatigue symptoms. Nonetheless, further research is needed to clarify conflicting results in the literature and substantiate the promising results from human trials on fatigue.

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“…These conclusions had a high impact not only on the pharmaceutical industry but also on the clinical practice: two of the most important guidelines changed dramatically the recommendation of the use of Gln. The Canadian Clinical Practice Guidelines (2016) [39] and ASPEN (2016) [40] downgraded the Gln supplementation based of the REDOX results and a series of studies that do not justify this.…”

Section: Enteral and Parenteral Glutamine Supplementationmentioning

confidence: 99%

Glutamine: A Conditionally Essential Amino Acid with Multiple Biological Functions

Leguina-Ruzzi¹,

Cariqueo²

2017

Superfood and Functional Food - The Development of Superfoods and Their Roles as Medicine

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Glutamine (Gln) is the most abundant free amino acid (AA) in the body with concentrations fluctuating around 500-900 μmol/L. The biological functions of Gln have been widely studied, and they have opened new targets because Gln could modulate physiological functions such as immune enhancer, muscular maintainer, nitrogen transporter, neuronal mediator, pH homeostasis, gluconeogenesis, amino sugar synthesis, and insulin release modulation. In 1990, it was identified that Gln is a conditionally essential AA, meaning that in hypercatabolic or stress conditions, the body suffers depletion in its circulating levels. Moreover, this condition is an independent risk factor of mortality, has been correlated with increase in infection rates, and length of hospital stay in intensive care units (ICU) patients. This characteristic confers the option of Gln use, meaning that through its targets, it could improve the outcome of patients who are suffering a hypercatabolic or hypermetabolic condition.

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A commentary on the 2015 Canadian Clinical Practice Guidelines in glutamine supplementation to parenteral nutrition

Cited by 7 publications

References 11 publications

Current Evidence for the Use of Smoflipid® Emulsion in Critical Care Patients for Parenteral Nutrition

Current Evidence for the Use of Smoflipid® Emulsion in Critical Care Patients for Parenteral Nutrition

Anti-Inflammatory Diets and Fatigue

Glutamine: A Conditionally Essential Amino Acid with Multiple Biological Functions

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