The effect of l-alanyl-l-glutamine dipeptide supplemented total parenteral nutrition on infectious morbidity and insulin sensitivity in critically ill patients*

Grau, T.; Bonet, Alfons; Miñambres, Eduardo; Piñeiro, Laura Villaverde; Irles, J. A.; Robles, Angel; Acosta, José A.; Herrero, Ignacio; Palacios, Venancio; Lopez, Jorge; Blesa, A.; Martínez, Pilar

doi:10.1097/ccm.0b013e31820eb774

Cited by 132 publications

(78 citation statements)

References 34 publications

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“…[87][88][89] In contrast, nutrition strategies, such as supplementation of PN with glutamine and the administration of low calorie PN, may reduce development of SH during critical illness. 90,91 In turn, SH can affect delivery of nutrition during critical illness in a variety of ways. Stress hyperglycemia may influence the ability to provide consistent or adequate EN during critical illness.…”

Section: Prolonged Immobility and Stress Hyperglycemiamentioning

confidence: 99%

Stress Hyperglycemia in Pediatric Critical Illness: The Intensive Care Unit Adds to the Stress!

Srinivasan

2012

J Diabetes Sci Technol

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Abbreviations: (BG), blood glucose, (CBP) cardiopulmonary bypass, (EN) enteral nutrition, (ECLS) extracorporeal life support, (FFA) free fatty acids, (GIR) glucose infusion rate, (GLUT) glucose transporter protein, (GH) growth hormone, (IGF-1) insulin-like growth factor-1, (ICU) intensive care unit, (IL-1) interleukin-1, (IL-6) interleukin-6, (PN) parenteral nutrition, (ROS) reactive oxygen species, (RRT) renal replacement therapy, (SH) stress hyperglycemia, (TGC) tight glucose control, (TNF-α) tumor necrosis factor-α

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Section: Prolonged Immobility and Stress Hyperglycemiamentioning

confidence: 99%

Stress Hyperglycemia in Pediatric Critical Illness: The Intensive Care Unit Adds to the Stress!

Srinivasan

2012

J Diabetes Sci Technol

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“…Grau et al (31) studied the effect of alanine-glutamine dipeptide supplemented TPN on incidence of nosocomial infections and found that TPN supplemented with alanine-glutamine in ICU patients is associated with reduced occurence rate of infectious complications. Although glutamine seems to have an effect on the immune system, antioxidant status and glucose metabolism, the benefit of exogenous glutamine on morbidity and mortality is not universally accepted (32).…”

Section: Discussionmentioning

confidence: 99%

GlutamineSupplementedParenteralNutritiontoPreventVentilatorAssociated Pneumonia in the Intensive Care Unit

Aydoğmuş¹,

Tomak²,

Tekïn³

et al. 2012

Balkan Med J

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Objective: Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN). We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU). Material and Methods:With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20), and the second was prescribed TPN (n=20) while the third group was given glutamine-supplemented TPN (n=20). C-reactive protein (CRP), sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs.Results: No statistically significant difference was found among groups in terms of development of VAP (p=0.622). Conclusion:Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP.

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“…Particularly in studies conducted after the 2000s, the addition of glutamine to the nutritional solutions of patients in critical care or undergoing surgery was shown to reduce the rates of infectious complications and mortality (38)(39)(40)(41). These studies were conducted on homogeneous groups of patients.…”

Section: Glutaminementioning

confidence: 99%

Malnutrition in Intensive Care Units: An Important Risk Factor for Intensive Care Unit-Acquired Infections

Gündoğan

Bayram²,

Alp

2015

Yoğun Bakim Derg

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Intensive care units have the highest prevalence of nosocomial infections in hospitals. Good nutritional support is essential to prevent nosocomial infections. However, malnutrition is a common and important problem in intensive care units, especially in developing countries. For the prevention of malnutrition, a team approach is needed. Immunonutrition is nutrition that affects the immune response in various ways and increases the strength of the immune system. Pharmaconutrition is the administration of immunonutrients over the daily recommended doses that act like pharmacological agents and drugs. The major immunonutrients are glutamine, arginine, omega-3 fatty acids, nucleotides, antioxidants (selenium, vitamin E, vitamin C, zinc, copper, and Nacetyl cysteine), probiotics, prebiotics, and synbiotics. The aim of this review is to highlight the pathophysiology and role of malnutrition in intensive care unit-acquired infections (ICU-AIs) and the use of immunonutrients to prevent ICU-AIs. (Yoğun Bakım Derg 2014; 5: 36-42)

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The effect of l-alanyl-l-glutamine dipeptide supplemented total parenteral nutrition on infectious morbidity and insulin sensitivity in critically ill patients*

Abstract: Total parenteral nutrition supplemented with alanine-glutamine in intensive care unit patients is associated with a reduced rate of infectious complications and better glycemic control.

Cited by 132 publications

References 34 publications

Stress Hyperglycemia in Pediatric Critical Illness: The Intensive Care Unit Adds to the Stress!

Stress Hyperglycemia in Pediatric Critical Illness: The Intensive Care Unit Adds to the Stress!

GlutamineSupplementedParenteralNutritiontoPreventVentilatorAssociated Pneumonia in the Intensive Care Unit

Malnutrition in Intensive Care Units: An Important Risk Factor for Intensive Care Unit-Acquired Infections

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