Glutamine Supplementation in Intensive Care Patients

Oldani, Massimo; Sandini, Marta; Nespoli, Luca; Coppola, Sara; Bernasconi, Davide Paolo; Gianotti, Luca

doi:10.1097/md.0000000000001319

Cited by 32 publications

(15 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, in subgroup analyses, infectious morbidity was reduced in patients receiving parenteral glutamine, for more than five days and with less severe disease. The authors speculated that glutamine does not have a protective effect on mortality in the most severe patients, since glutamine supplementation is not sufficient for recovery of organ dysfunction, which is the main determinant of death in these cases [ 12 ]. In contrast, the “GLND” trial, a prospective, randomized, controlled, double-blind, multicenter, phase III study that investigated the safety and clinical efficacy of glutamine dipeptide-supplemented parenteral nutrition showed that glutamine supplementation is safe, but did not improve clinical outcomes, as well as hospital infections, in surgical ICU patients after gastrointestinal, vascular, or cardiac surgery.…”

Section: Glutamine Therapy In Respiratory Diseasesmentioning

confidence: 99%

“…Compared to an isonitrogenous control, enteral glutamine had no impact on outcomes in this general population of ICU patients, but reduced in-hospital mortality in burn patients [ 11 ]. In a systematic review and meta-analysis including clinical trials of patients admitted to ICU that used both parenteral and enteral glutamine, supplementation was not found to reduce in-hospital mortality, ICU mortality, or the rate of infection [ 12 ]. Thus, the effect of glutamine appears to depend on the route of administration, and parenteral supplementation may lead to better results.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Exogenous Glutamine in Respiratory Diseases: Myth or Reality?

et al. 2016

View full text Add to dashboard Cite

Several respiratory diseases feature increased inflammatory response and catabolic activity, which are associated with glutamine depletion; thus, the benefits of exogenous glutamine administration have been evaluated in clinical trials and models of different respiratory diseases. Recent reviews and meta-analyses have focused on the effects and mechanisms of action of glutamine in a general population of critical care patients or in different models of injury. However, little information is available about the role of glutamine in respiratory diseases. The aim of the present review is to discuss the evidence of glutamine depletion in cystic fibrosis (CF), asthma, chronic obstructive pulmonary disease (COPD), acute respiratory distress syndrome (ARDS), and lung cancer, as well as the results of exogenous glutamine administration in experimental and clinical studies. Exogenous glutamine administration might be beneficial in ARDS, asthma, and during lung cancer treatment, thus representing a potential therapeutic tool in these conditions. Further experimental and large randomized clinical trials focusing on the development and progression of respiratory diseases are necessary to elucidate the effects and possible therapeutic role of glutamine in this setting.

show abstract

Section: Glutamine Therapy In Respiratory Diseasesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exogenous Glutamine in Respiratory Diseases: Myth or Reality?

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Glutamine deficiency contributes to the dysfunction of the immune system and increased mortality [40,61]. Meta-analyses of randomized studies suggest that glutamine and antioxidant supplementation in critically ill patients may be associated with prolonged survival [62,63].…”

Section: Immunomodulatory Nutritionmentioning

confidence: 99%

Clinical Nutrition of Critically Ill Patients in the Context of the Latest ESPEN Guidelines

et al. 2019

View full text Add to dashboard Cite

The group of patients most frequently in need of nutritional support are intensive care patients. This year (i.e., 2019), new European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines of clinical nutrition in intensive care were published, updating and gathering current knowledge on the subject of this group of patients. Planning the right nutritional intervention is often a challenging task involving the necessity of the choice of the enteral nutrition (EN) or parenteral nutrition (PN) route of administration, time of initiation, energy demand, amino acid content and demand as well as the use of immunomodulatory nutrition. The aim of this study was to specify and discuss the basic aspects of the clinical nutrition of critically ill patients recommended by ESPEN guidelines. Clinical nutrition in intensive care seems to be the best-studied type of nutritional intervention. However, meta-analyses and clinical studies comparing EN and PN and their impact on the prognosis of the intensive care patients showed ambiguous results. The nutritional interventions, starting with EN, should be initiated within 24–48 h whereas PN, if recommended, should be implemented within 3–7 days. The recommended method of calculation of the energy demand is indirect calorimetry, however, there are also validated equations used worldwide in everyday practice. The recommended protein intake in this group of patients and the results of insufficient or too high supply was addressed. In light of the concept of immunomodulatory nutrition, the use of appropriate amino acid solutions and lipid emulsion that can bring a positive effect on the modulation of the immune response was discussed.

show abstract

“…However, in a recent study with intensive care unit (ICU) patients, it has been encountered that TPN supplemented with glutamine dipeptide is safe, but does not alter clinical outcomes among the patients [302], while clinical trials have not demonstrated prolonged advantages, such as reductions in mortality or risk of infections in adults [303]. In a recent meta-analysis of randomized clinical trials [304], no difference has been found to allow the recommendation of glutamine supplementation to generic population of critically ills. Therefore, the efficacy of glutamine supplementation is still under debate.…”

Section: Physical Exercise Glutamine and Hs Response In Agingmentioning

confidence: 99%

Physiological regulation of the heat shock response by glutamine: implications for chronic low-grade inflammatory diseases in age-related conditions

Leite

Cruzat

Krause

et al. 2016

Nutrire

View full text Add to dashboard Cite

Aging is an intricate process modulated by different molecular and cellular events, such as genome instability, epigenetic and transcriptional changes, molecular damage, cell death and senescence, inflammation, and metabolic dysfunction. Particularly, protein quality control (chaperone systems) tends to be negatively affected by aging, thus leading to cellular senescence in metabolic tissues and, as a consequence, to the increasing dissemination of inflammation throughout the body. The heat shock (HS) response and its associated expression of the 70 kDa family of heat shock proteins (HSP70), which are anti-inflammatory molecular chaperones, are found to be markedly decreased during muscle inactivity and aging, while evidence supports the loss of HSP70 as a key mechanism which may drive muscle atrophy, contractile dysfunction, and reduced regenerative capacity. In addition, abnormal stress response is linked with higher incidence of neurodegenerative diseases as well as low-grade inflammatory diseases that are associated with physical inactivity and obesity. Therefore, strategies to increase or, at least, to maintain the levels of HSP70, and its accompanying HS response to stress, are key to reduce biological cell dysfunctions that occur in aging. In this sense, physical exercise is of note as it is the most powerful inducer of the HS response, comparable only to heat stress and fever-like conditions. On the other hand, the amino acid L-glutamine, whose production within the skeletal muscle and liberation into the blood stream is dependent on muscle activity, is a potentializer of HSP70 expression and HS response, particularly via its entering in hexosamine biosynthetic pathway (HBP). Herein, we discuss the collaborative role of glutamine (and its donors/precursors) and physical exercise (mostly responsible for glutamine release into the circulation) as potential tools to increase HSP70 expression and the HS response in the elderly.

show abstract

Glutamine Supplementation in Intensive Care Patients

Cited by 32 publications

References 63 publications

Exogenous Glutamine in Respiratory Diseases: Myth or Reality?

Exogenous Glutamine in Respiratory Diseases: Myth or Reality?

Clinical Nutrition of Critically Ill Patients in the Context of the Latest ESPEN Guidelines

Physiological regulation of the heat shock response by glutamine: implications for chronic low-grade inflammatory diseases in age-related conditions

Contact Info

Product

Resources

About