Efficacy of Glutamine‐Enriched Nutrition Support for Patients With Severe Acute Pancreatitis

Yong, Li; Lu, Qiping; Liu, Shenghui; Hu, Fan

doi:10.1177/0148607115570391

Cited by 43 publications

(32 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is thought to be due to the higher bioavailability of glutamine through parenteral administration, whereas enteral glutamine is used by the gut, therefore the immune system outside the gut would not have been affected by enteral glutamine supplementation. However, only one of the eight meta-analyses that performed a subgroup analysis on administration type presented a significant difference between parenteral and enteral administration, and this meta-analysis found that the length of stay in hospital was significantly shortened for the enteral route (4.5 days less for enteral vs. 2.5 days less for parenteral) (23). To confuse matters more, the only two meta-analyses on clinical studies that used enteral glutamine supplementation with critically ill patients demonstrated completely opposite effects on length of stay in hospital with one presenting a 4.73 day reduction and the other with a 0.19 day reduction (it should be noted that these two findings represent the two extremes from the 18 meta-analyses in this category) (24,32).…”

Section: Discussionmentioning

confidence: 89%

Therapeutic benefits of glutamine: An umbrella review of meta-analyses

McRae

2017

Biomedical Reports

View full text Add to dashboard Cite

Abstract. Glutamine may be an essential amino acid in patients with catabolic disease, as it has been demonstrated that circulating glutamine levels drop during critical illness and following major surgery; this may result in an increase in secondary infection risk, recovery time and mortality rates. However, there is much discrepancy in the literature with regards to randomized controlled studies, and therefore, the present study is an umbrella review of published meta-analyses, conducted to examine the effectiveness of glutamine's role as a therapeutic agent. A search using PubMed, Cochrane Library and CINAHL from January 1st, 1980 to December 31st, 2016 was conducted using the following strategy: 'Glutamine AND (meta-analysis OR systematic review)' and publications were retrieved, which provided quantitative statistical analysis of pooled treatment effects on the relative risks of infectious complications, mortality and length of stay in hospital. A total of 22 meta-analyses were entered into the current umbrella review. As displayed in Tables I, II and III, these analyses are split into three groups, based on different parameters. Of the 19 meta-analyses investigating the effects of infectious complications, 15 identified statistically significant reductions in complications, with relative risks ranging between 0.42 and 0.93. In addition, 12 of the 18 meta-analyses analyzing the length of hospital stays presented statistically significant reductions in the length of stay, with reductions ranging between 0.19 to 4.73 days. Only 4 of the 15 meta-analyses studying mortality effects identified statistically significant reductions in mortality with relative risks ranging between 0.64 and 1.28. Statistically significant heterogeneity was observed in 16 of 22 meta-analyses, and publication bias was observed in five of 11 meta-analyses. Glutamine supplementation for critically ill or surgical patients through parenteral or enteral routes appears to reduce the rate of hospital acquired infectious complications and shortening of the length of stay in hospital. Furthermore, glutamine supplementation appeared to reduce the rate of in-patient mortality, but the majority of meta-analyses did not reach statistical significance. However, researchers must appreciate the positive results with caution in light of the fact that there exists statistically significant heterogeneity for the majority of meta-analyses, and statistically significant publication bias in almost half.

show abstract

Section: Discussionmentioning

confidence: 89%

Therapeutic benefits of glutamine: An umbrella review of meta-analyses

McRae

2017

Biomedical Reports

View full text Add to dashboard Cite

show abstract

“…Based on these findings, 8 TAs with the best‐quality evidence were selected for further analysis, as prioritized by points on rubric scores (Table ). They included cross‐disease malnutrition, sepsis, surgical complications, HACs, congestive heart failure, COPD, GI cancer, and pancreatitis …”

Section: Resultsmentioning

confidence: 99%

Value of Nutrition Support Therapy: Impact on Clinical and Economic Outcomes in the United States

Tyler

Barrocas

Guenter

et al. 2020

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Objective Healthcare leaders seek guidance on prudent investment in programs that improve patient outcomes and reduce costs, which includes the value of nutrition therapy. The purpose of this project was to conduct an evidence review and evaluate claims analyses to understand the financial and quality impact of nutrition support therapy on high‐priority therapeutic conditions. Methods Task 1 included a review of existing literature from 2013 to 2018 to identify evidence that demonstrated the clinical and economic impact of nutrition intervention on patient outcomes across 13 therapeutic areas (TAs). In Task 2, analytic claims modeling was performed using the Medicare Parts A and B claims 5% sample dataset. Beneficiaries diagnosed in 5 selected TAs (sepsis, gastrointestinal [GI] cancer, hospital‐acquired infections, surgical complications, and pancreatitis) were identified in the studies from Task 1, and their care costs were modeled based on nutrition intervention. Results Beginning with 1099 identified articles, 43 articles met the criteria, with a final 8 articles used for the Medicare claims modeling. As examples of the modeling demonstrated, the use of advanced enteral nutrition formula could save at least $52 million annually in a sepsis population. The total projected annual cost savings from the 5 TAs was $580 million. Conclusion Overall, optimization of nutrition support therapy for specific patient populations is estimated to reduce Medicare spending by millions of dollars per year across key TAs. These findings demonstrate the evidence‐based value proposition of timely nutrition support to improve clinical outcomes and yield substantial cost savings.

show abstract

“…U usporedbi sa standardnom enteralnom potporom nadoknada glutamina rezultirala je kraćim boravkom u bolnici, sniženom incidencijom infektivnih komplikacija i mortaliteta, a intravenska nadoknada pokazala se boljim izborom zbog bolje bioraspoloživosti. 61 Što se tiče upalnih bolesti crijeva, Cochraneova sistematska analiza koja je obuhvatila samo dva RCT-a s ukupno 42 bolesnika zaključila je da nema dovoljno dokaza o učinkovitosti i sigurnosti glutamina u indukciji remisije pri Crohnovoj bolesti. 62…”

Section: Glutaminunclassified

Enteral Nutrition – Where Are We Today in Pharmaconutrition?

2018

View full text Add to dashboard Cite

nekoliko desetljeća dostupan nam je velik izbor enteralnih formula za različite indikacije. Koncept kliničke prehrane s vremenom je evoluirao od nutritivne potpore koja ima cilj samo zadovoljiti energetske potrebe bolesnika do one koja može utjecati i na sam tijek bolesti. Iako za određene farmakološki aktivne tvari u enteralnim pripravcima, kao što su različite aminokiseline i njihovi metaboliti, ω-3 masne kiseline, nukleotidi i antioksidansi, postoje dokazi da mogu utjecati na upalne i imunološke funkcije, pozitivan utjecaj imunomodulirajućih nutrijenata na klinički ishod u određenim je uvjetima bilo vrlo teško dokazati, usprkos velikom broju kliničkih istraživanja u ovom području. Moguća objašnjenja za ove proturječnosti kriju se u nedovoljno precizno utvrđenim mehanizmima djelovanja, vremenu i načinu davanja, dozi, a napose vrsti i tijeku bolesti u kojoj su se primjenjivali. Svrha je ovog pregleda objasniti potencijalno korisne fi ziološke mehanizme djelovanja najčešće upotrebljavanih farmakonutrijenata i prezentirati kliničke dokaze o njihovoj uporabi.Summary. Enteral nutrition formulas have been created over the past several decades with a variety of intended uses. Over the past two decades, the focus has shifted to the administration of pharmacologically active substances, such as different amino acids and their metabolites, ω-3 fatty acids, nucleotides and antioxidants in an attempt to modulate the infl ammatory or immune response and affect clinical outcomes. Although some pharmaconutrients have clearly demonstrated the ability to potentiate, antagonize, or otherwise modify metabolic functions, despite the large volume of clinical research in this area, undoubted benefi t of immunomodulating diets in certain clinical settings was diffi cult to prove. Potential explanations for discrepancies include variable effects of individual nutrients dependent on dose, nutrient interactions, timing of delivery and different metabolic needs of heterogeneous patient population. The purpose of this review is to cover potential benefi cial physiological mechanisms for some common individual pharmaconutrients and briefl y describe some of the current clinical data regarding their use. Liječ Vjesn 2018;140:50-56 * Hrvatsko društvo za kliničku prehranu Hrvatskoga liječničkog zbora (prim. dr. sc. Tajana Pavić, dr. med.; doc. dr. sc. Darija Vranešić Ben der, dipl. ing.; prof. dr. sc. Željko Krznarić, dr. med.), Hrvatsko društvo za gerontologiju i gerijatriju Hrvatskoga liječničkog zbora (doc. dr. sc. Spomenka Tomek-Roksandić, dr. med.) Adresa za dopisivanje: Prim. dr. sc. T. Pavić, Zavod za gastroenterologiju i hepatologiju, Klinika za unutarnje bolesti, KBC Sestre milosrdnice,

show abstract

Efficacy of Glutamine‐Enriched Nutrition Support for Patients With Severe Acute Pancreatitis

Abstract: Gln-enriched nutrition support is superior to conventional methods for SAP, and intravenous infusion may be a better choice for drug administration.

Cited by 43 publications

References 24 publications

Therapeutic benefits of glutamine: An umbrella review of meta-analyses

Therapeutic benefits of glutamine: An umbrella review of meta-analyses

Value of Nutrition Support Therapy: Impact on Clinical and Economic Outcomes in the United States

Enteral Nutrition – Where Are We Today in Pharmaconutrition?

Contact Info

Product

Resources

About